"Mr. Adair, you've had a heart attack"
Chilling words, to be sure… especially on my 27th birthday in A.A. We call it a “birthday” because it’s supposed to be a grand and glorious day celebrating the annual anniversary of one’s last drink of alcohol. For the uninitiated, this is probably THE most important day of any alcoholic’s life,
throughout the world. It supersedes Christmas, Thanksgiving, July 4th, or natal birthdays by a long shot.
Mine was going to be celebrated by doing one of my favorite activities, going for a ride on my bike. A little explanation might be helpful; for the last seven years, I’ve ridden my bike in “RAGBRAI”. It’s a 500+ mile ride across Iowa in the high heat of the summertime. It’s billed as the longest, largest, organized bike ride in the world; and takes place every year through the cornfields of Iowa. Just the day before, I went to “spin-class”, (a rigorous, instructor-driven bicycle class ), and nailed it. In fact, I felt so good, I went into the weight room afterward to pump some iron. All in all, I was invigorated – life was good – the universe was in order – and the only way it could get any better was: if I hit“Megabucks” at a local casino, (which would be hard to do, since I don’t gamble.)
My wife, Cecelia, and I planned the Sunday ride practically all week long. We prepared food, water, bike-gear, etc., and figured we’d start about 7:00 Sunday morning. I had recently gotten my bike out of the shop from it’s annual spring tune-up, and was anxious to “try her out”, and see how she felt. I remember thinking as I got on my bike, that…”this is delicious, it’s absolutely great to be back in the saddle and doing my first outside ride of the year on “Bones”, (the name of my bike, because it has skeletal bones painted on the long portions of the frame.) We started from our home and planned to ride to the Red Rock Visitor’s Center, approximately 13 miles away. 13 miles sounds like a short distance, I’m sure; the thing to bear in mind is that it’s 13 miles UPHILL. Now, it’s not climbing Pike’s Peak or anything, but it IS an effort… and if you think about it… that’s what one wants for a -- training ride, especially if you planning to ride the hills of Iowa.
There was no essence of any kind of upcoming event as we got on our way; no“shortness of breath”, stinging arm, or anything else that could be mildly described as heart-associated. The first part of the ride is approximately 5 miles and takes you to the intersection of Ft. Apache & Charleston streets. We stopped briefly there, “watered” up, and continued to the next stopping point, where the perimeter crosses Charleston, (another 5 miles.) As we topped out, I DID notice that I was a might more tired than I thought I should be. However, since I had done this particular run at least 50 times in the past, I chalked it up to the “first ride of the season”, and put it out of my mind and continued to peddle. When I was 11 miles into the ride, I began to notice a pain, kind of like a mild cramp in my chest, just to the left of the sternum. “Huh…”, I silently said to myself as I continued on. I automatically assumed it was probably a pulled muscle from pumping a little iron on the previous day. The pain grew a touch more intense and I squirmed around on my bicycle seat a little more, hoping to “settle-in” a bit and maybe the pain would go away. The pain continued it’s current intensity of being not really too painful, but, not really unnoticed either. I got off my bike, then got on my bike; arched my back like a cat, raised my arms over my head and stretched; farted; coughed, drank some more water, and spit several times – all to no avail… Mister Pain had joined me on my bike ride and there was no getting rid of him.
So,“What the heck”, right?? – I’ve ridden in pain before, and today I was just going to have to ignore it, like I had done numerous times in the past. So, I continued on. Cecelia was riding about 40 yards in front of me, and I remember thinking, “Huh, how come she’s in front of me so far?? I never ride this slow.”I looked at the computer on my bike and it read 7 MPH… SEVEN miles per hour?? “Christ, Ray Charles can ride faster than that, and he’s dead”, I silently said to myself as I attempted to peddle a little harder. BUT… even though I tried… I couldn’t peddle any harder. I thought silently, “You don’t suppose I’ve got an actual problem going on here, do ya?” “Nah, couldn’t be, hell, I played in a racquetball tournament earlier this month, and was captain of the team. I coached them myself and made them play ME… My singles-guy took second place, and my doubles-team took first place, and the two of them, together couldn’t beat me, while I was training them, nor could my singles-guy. I COULDN’T be having a heart attack.”
I rode on… not very far though, because no matter how hard I tried, I wasn’t making any headway toward Cecelia; AND, the damn computer wouldn’t budge past 7 MPH. I remember thinking at the time, “I hate to pay good money for junk, as soon as I get a chance, I’m taking this computer back and getting my money back.” (Mister Pain said he thought that would be a good idea.) I made about 3 more turns on the peddles and realized it was useless. I looked up at Cecelia, gave her a whistle, and stopped… Mister Pain snd I got off the bike and just stood there. For the first time in my life, I couldn’t “go”… I felt like John Henry, who couldn’t swing his hammer any more. I saw the sad look in my wife’s eyes as I told her I had to sit down. (Mind you, I’m sitting down on a short downhill portion of the ride, that I should be gliding down.) I sat there for several minutes, alternating between drinking water, (secretly hoping to wash the pain out of my chest), and spitting, the way nervous baseball players do in the World Series.
It began to dawn on me that I just might be in serious trouble. Here I was… in the middle of nowhere… probably having a heart attack… and no way out. I told my wife, “Honey, I think we better turn around”, she just stared at me in questioning shock, as she nodded and said – “Whatever you think is best.” We crossed to the other side of the road and got back on our bikes. Cecelia said she would ride behind me to make sure I was alright. I started to peddle and was thankful the ride back to our house was all down hill. Even though it was a significant grade, I still had somewhat of a hard time negotiating it. My mind seemed a little fuzzy as I tried to decide which way to go on a route that I had been on so many times before, it practically had my tire prints in it.
Finally, we made it home. I immediately went to the living room and slumped on the couch. Cecelia asked if she could get me anything and I told her: “Maybe a cold glass of water and some aspirin.” She came back with the water and pills, and I swallowed 3 and drank all the water. I thought silently to myself, “I’m gonna wait a few minutes, then take 3 more, and if that doesn’t do it… I’m going to the hospital.” I waited… nothing… in fact, the pain was even slightly more intense. I took the second trio, -- waited… still nothing, no relief at all. I thought maybe if I lay down, it might get better, so I drug myself into the bedroom and sprawled out on the bed. If anything, that was even worse.
So, with heavy heart, (literally), I told Cecelia, “Honey, I may be in trouble here, why don’t we go to the hospital.”She didn’t blink an eye, and we got in her car and went to a local hospital called, Summerlin. I walked up to the admitting desk and sat down. The administrator behind the desk asked, “How can I help you today?” I said, “Uh, I’m having some chest pain, (not wanting to say the words I already knew were true.)” Apparently, that was all she needed to hear, because you could almost hear the dominoes beginning to fall. In short order, I was taken into an anteroom adjacent to the admitting area. They started questioning me as to what had happened, and I was definitely in full disclosure. In seconds it seemed, I was on a gurney and being wheeled back to the emergency area. A poke here, a needle there… “Mr. Adair, this is a blood thinner; Mr. Adair, this is a spray under your tongue, it’s nitroglycerine, it’ll help your heart beat easier. Mr. Adair, this is a nitro-patch, it’ll aid your heart, and is more long-lasting; Mr. Adair… this is an EKG-machine, it’ll tell us the condition of your heart. Mr. Adair… Mr. Adair…” -- “How’s that pain, by the way?” -- “Oh, it’s still there”, I barely managed, as I silently prayed to my Higher Power.
After the initial treatment, they parked me in the hall, under the letter “B”. I tried to think of any cosmic association with it, then looked around the hall and realized there were 7 or 8 others with me, under their own respective letters. It seemed like every five minutes or so, someone would be taking my blood pressure, poking me with yet another fluid, or asking how I felt. All I knew was that I was – tired, scared, and in pain. It turned out that Mister Pain was my new best friend. They asked me initially to rate the pain on a scale of 1 to 10. My first rating was a full blown 7. It was interesting to watch the numbers decrease as the day wore on. “Mr. Adair, how is it?”, an attractive nurse named Holly said. – “About a 6, no, 5.” Then, 4, 3, 2,… And somewhere around 6:00 in the evening I arrived at ZERO… With relief, I said a quick goodbye to Mister Pain, hoping I wouldn’t see him anymore.
That evening began the “process”. It’s a process to get all the ducks in a row to diagnose and treat a heart attack. First, you have to make sure what it isn’t. They did EKGs practically every hour. They took a chest X-Ray to rule out congestive heart failure. They did an echo-cardiogram, literally an ultrasound of the heart – while functioning, to see how much damage has been done. (I was pretty interested in that last one.) And, finally, they told me they were going to do an angiogram. In this process, they puncture the femoral artery in the upper thigh and insert a wire called a catheter. They then maneuver the wire till its in the left ventricle of the heart and release some X-Ray opaque dye. From that, they can tell where the blockage(s) is. Before they did the procedure, I asked my cardiologist what were the possible outcomes. He said the best of all scenarios would be if there was only one blockage, the worst was none. The reasoning was – if they found 3 or more, then I had to have by-pass, or open-heart surgery. If they found none… well, I HAD had a heart attack;, and if they couldn’t find a reason for it, I would remain in jeopardy.
The first angiogram was purely diagnostic and clearly showed I had a “LAD” blockage, (Left Anterior Descending.) The tough thing was lying flat on my back after the procedure. If you’re curious, lie down on your bed, say at 4:00 in the afternoon, and don’t move till 8:00; you’ll get the picture. Oh, by the way, do it as if your life depends on it! (Because mine did.)
The second angiogram was the real deal. At 3:00 in the afternoon, two young lads from the Cath-Lab came up to retrieve me. They joked with me and seemed full of confidence as they wheeled me down to the lab. The prep was quick and efficient; a quick shave here (ahem), a quick shave there; a little Betadine to knock off any lingering germs, and a gulp and swallow from me. Then Doug, one of the Cath-Techs, said, “Tom, I think you’re going to like this.”; and the next thing I knew, I was impressed by how far the world of drugs had come. I was awake of course, but not quite “there”. The biggest side effect was that my nose itched. I asked ol’ Doug several times to scratch it for me. In what seemed like only 10 minutes or so, the doc leaned over and said it went“fabulous”. I told him I bet he told all his patients that. He smiled a warm smile and said, “In all seriousness, Tom… this is as good as it gets; a text-book, classroom procedure that was as good as I’ve ever done.” I smiled back as he left the lab to go tell my wife the good news.
After I came back from the Cath-Lab, a robust nurse named Terry came over to my bedside and introduced herself. She said, “Tom, this is pretty important. I’m going to have to take these sheaths, (long, plastic, guide tubes for the catheter), out of your leg. I want you to lie still while I do it. Then, I’m going to have to keep a hard pressure on it for about twenty minutes. You’re probably going to bruise from this, but it’s necessary.” I told her I was pretty good at enduring pain, and the fun began. True to her word, she put enormous pressure on my leg. I told her if she ever considered an alternative career, perhaps wrestling might be worthy of consideration. I watched her as she watched me, and we both glanced at the clock, counting down the minutes. Finally, it was past the required twenty. “Whew”, I thought, “what a relief”, (in more ways than one.)
That night was a long one. My beautiful wife stayed by my side deep into the night as we counted down the first critical hours. Thankfully, there was no bleeding and I knew I would be all right. My back was killing me from being flat and without movement, so a gracious nurse gave me a light shot of Demerol to ease my pain. By midnight, I could move again. What freedom… what release… I almost cried. Morning came slow and hard. It seemed like every time I looked at the clock it said the same thing, (“quit looking at me, or my hands will never move.”) So, that was the game I played, see how long I could keep from looking at the hands on the wall clock. I think the best I ever did was 6 minutes. It’s true what they say, “a watched clock never boils”; at least that one never did. As for as I was concerned, it was barely turned on. But, I made it. Through one of the longest nights of my life, I saw God’s holy light breaking through my window. I reflected that – several days ago I wouldn’t have bet a lot that I would ever see another beautiful desert sunrise.
You have to go without food for quite a long time before an angiogram, and that morning’s breakfast of barely warm scrambled eggs, and damp toast was pretty good. I’m sure I had smiles all over my face as various staff came by to see how I was doing. I nodded and smiled at everyone I saw. I wanted everyone to know how good it felt to be alive.
They discharged me that afternoon, and my wife took me home. My dog, Dillon, was practically levitating he was so glad to see me. As to the conclusion, -- well, as the Doc said, “You have no restrictions; go and enjoy life; do what you want to do; I’m sure you’ll find what’s right for you. One more thing, make an appointment with me in about 4 weeks, I want to see how you’re doing. Get out of here, lucky man.”
throughout the world. It supersedes Christmas, Thanksgiving, July 4th, or natal birthdays by a long shot.
Mine was going to be celebrated by doing one of my favorite activities, going for a ride on my bike. A little explanation might be helpful; for the last seven years, I’ve ridden my bike in “RAGBRAI”. It’s a 500+ mile ride across Iowa in the high heat of the summertime. It’s billed as the longest, largest, organized bike ride in the world; and takes place every year through the cornfields of Iowa. Just the day before, I went to “spin-class”, (a rigorous, instructor-driven bicycle class ), and nailed it. In fact, I felt so good, I went into the weight room afterward to pump some iron. All in all, I was invigorated – life was good – the universe was in order – and the only way it could get any better was: if I hit“Megabucks” at a local casino, (which would be hard to do, since I don’t gamble.)
My wife, Cecelia, and I planned the Sunday ride practically all week long. We prepared food, water, bike-gear, etc., and figured we’d start about 7:00 Sunday morning. I had recently gotten my bike out of the shop from it’s annual spring tune-up, and was anxious to “try her out”, and see how she felt. I remember thinking as I got on my bike, that…”this is delicious, it’s absolutely great to be back in the saddle and doing my first outside ride of the year on “Bones”, (the name of my bike, because it has skeletal bones painted on the long portions of the frame.) We started from our home and planned to ride to the Red Rock Visitor’s Center, approximately 13 miles away. 13 miles sounds like a short distance, I’m sure; the thing to bear in mind is that it’s 13 miles UPHILL. Now, it’s not climbing Pike’s Peak or anything, but it IS an effort… and if you think about it… that’s what one wants for a -- training ride, especially if you planning to ride the hills of Iowa.
There was no essence of any kind of upcoming event as we got on our way; no“shortness of breath”, stinging arm, or anything else that could be mildly described as heart-associated. The first part of the ride is approximately 5 miles and takes you to the intersection of Ft. Apache & Charleston streets. We stopped briefly there, “watered” up, and continued to the next stopping point, where the perimeter crosses Charleston, (another 5 miles.) As we topped out, I DID notice that I was a might more tired than I thought I should be. However, since I had done this particular run at least 50 times in the past, I chalked it up to the “first ride of the season”, and put it out of my mind and continued to peddle. When I was 11 miles into the ride, I began to notice a pain, kind of like a mild cramp in my chest, just to the left of the sternum. “Huh…”, I silently said to myself as I continued on. I automatically assumed it was probably a pulled muscle from pumping a little iron on the previous day. The pain grew a touch more intense and I squirmed around on my bicycle seat a little more, hoping to “settle-in” a bit and maybe the pain would go away. The pain continued it’s current intensity of being not really too painful, but, not really unnoticed either. I got off my bike, then got on my bike; arched my back like a cat, raised my arms over my head and stretched; farted; coughed, drank some more water, and spit several times – all to no avail… Mister Pain had joined me on my bike ride and there was no getting rid of him.
So,“What the heck”, right?? – I’ve ridden in pain before, and today I was just going to have to ignore it, like I had done numerous times in the past. So, I continued on. Cecelia was riding about 40 yards in front of me, and I remember thinking, “Huh, how come she’s in front of me so far?? I never ride this slow.”I looked at the computer on my bike and it read 7 MPH… SEVEN miles per hour?? “Christ, Ray Charles can ride faster than that, and he’s dead”, I silently said to myself as I attempted to peddle a little harder. BUT… even though I tried… I couldn’t peddle any harder. I thought silently, “You don’t suppose I’ve got an actual problem going on here, do ya?” “Nah, couldn’t be, hell, I played in a racquetball tournament earlier this month, and was captain of the team. I coached them myself and made them play ME… My singles-guy took second place, and my doubles-team took first place, and the two of them, together couldn’t beat me, while I was training them, nor could my singles-guy. I COULDN’T be having a heart attack.”
I rode on… not very far though, because no matter how hard I tried, I wasn’t making any headway toward Cecelia; AND, the damn computer wouldn’t budge past 7 MPH. I remember thinking at the time, “I hate to pay good money for junk, as soon as I get a chance, I’m taking this computer back and getting my money back.” (Mister Pain said he thought that would be a good idea.) I made about 3 more turns on the peddles and realized it was useless. I looked up at Cecelia, gave her a whistle, and stopped… Mister Pain snd I got off the bike and just stood there. For the first time in my life, I couldn’t “go”… I felt like John Henry, who couldn’t swing his hammer any more. I saw the sad look in my wife’s eyes as I told her I had to sit down. (Mind you, I’m sitting down on a short downhill portion of the ride, that I should be gliding down.) I sat there for several minutes, alternating between drinking water, (secretly hoping to wash the pain out of my chest), and spitting, the way nervous baseball players do in the World Series.
It began to dawn on me that I just might be in serious trouble. Here I was… in the middle of nowhere… probably having a heart attack… and no way out. I told my wife, “Honey, I think we better turn around”, she just stared at me in questioning shock, as she nodded and said – “Whatever you think is best.” We crossed to the other side of the road and got back on our bikes. Cecelia said she would ride behind me to make sure I was alright. I started to peddle and was thankful the ride back to our house was all down hill. Even though it was a significant grade, I still had somewhat of a hard time negotiating it. My mind seemed a little fuzzy as I tried to decide which way to go on a route that I had been on so many times before, it practically had my tire prints in it.
Finally, we made it home. I immediately went to the living room and slumped on the couch. Cecelia asked if she could get me anything and I told her: “Maybe a cold glass of water and some aspirin.” She came back with the water and pills, and I swallowed 3 and drank all the water. I thought silently to myself, “I’m gonna wait a few minutes, then take 3 more, and if that doesn’t do it… I’m going to the hospital.” I waited… nothing… in fact, the pain was even slightly more intense. I took the second trio, -- waited… still nothing, no relief at all. I thought maybe if I lay down, it might get better, so I drug myself into the bedroom and sprawled out on the bed. If anything, that was even worse.
So, with heavy heart, (literally), I told Cecelia, “Honey, I may be in trouble here, why don’t we go to the hospital.”She didn’t blink an eye, and we got in her car and went to a local hospital called, Summerlin. I walked up to the admitting desk and sat down. The administrator behind the desk asked, “How can I help you today?” I said, “Uh, I’m having some chest pain, (not wanting to say the words I already knew were true.)” Apparently, that was all she needed to hear, because you could almost hear the dominoes beginning to fall. In short order, I was taken into an anteroom adjacent to the admitting area. They started questioning me as to what had happened, and I was definitely in full disclosure. In seconds it seemed, I was on a gurney and being wheeled back to the emergency area. A poke here, a needle there… “Mr. Adair, this is a blood thinner; Mr. Adair, this is a spray under your tongue, it’s nitroglycerine, it’ll help your heart beat easier. Mr. Adair, this is a nitro-patch, it’ll aid your heart, and is more long-lasting; Mr. Adair… this is an EKG-machine, it’ll tell us the condition of your heart. Mr. Adair… Mr. Adair…” -- “How’s that pain, by the way?” -- “Oh, it’s still there”, I barely managed, as I silently prayed to my Higher Power.
After the initial treatment, they parked me in the hall, under the letter “B”. I tried to think of any cosmic association with it, then looked around the hall and realized there were 7 or 8 others with me, under their own respective letters. It seemed like every five minutes or so, someone would be taking my blood pressure, poking me with yet another fluid, or asking how I felt. All I knew was that I was – tired, scared, and in pain. It turned out that Mister Pain was my new best friend. They asked me initially to rate the pain on a scale of 1 to 10. My first rating was a full blown 7. It was interesting to watch the numbers decrease as the day wore on. “Mr. Adair, how is it?”, an attractive nurse named Holly said. – “About a 6, no, 5.” Then, 4, 3, 2,… And somewhere around 6:00 in the evening I arrived at ZERO… With relief, I said a quick goodbye to Mister Pain, hoping I wouldn’t see him anymore.
That evening began the “process”. It’s a process to get all the ducks in a row to diagnose and treat a heart attack. First, you have to make sure what it isn’t. They did EKGs practically every hour. They took a chest X-Ray to rule out congestive heart failure. They did an echo-cardiogram, literally an ultrasound of the heart – while functioning, to see how much damage has been done. (I was pretty interested in that last one.) And, finally, they told me they were going to do an angiogram. In this process, they puncture the femoral artery in the upper thigh and insert a wire called a catheter. They then maneuver the wire till its in the left ventricle of the heart and release some X-Ray opaque dye. From that, they can tell where the blockage(s) is. Before they did the procedure, I asked my cardiologist what were the possible outcomes. He said the best of all scenarios would be if there was only one blockage, the worst was none. The reasoning was – if they found 3 or more, then I had to have by-pass, or open-heart surgery. If they found none… well, I HAD had a heart attack;, and if they couldn’t find a reason for it, I would remain in jeopardy.
The first angiogram was purely diagnostic and clearly showed I had a “LAD” blockage, (Left Anterior Descending.) The tough thing was lying flat on my back after the procedure. If you’re curious, lie down on your bed, say at 4:00 in the afternoon, and don’t move till 8:00; you’ll get the picture. Oh, by the way, do it as if your life depends on it! (Because mine did.)
The second angiogram was the real deal. At 3:00 in the afternoon, two young lads from the Cath-Lab came up to retrieve me. They joked with me and seemed full of confidence as they wheeled me down to the lab. The prep was quick and efficient; a quick shave here (ahem), a quick shave there; a little Betadine to knock off any lingering germs, and a gulp and swallow from me. Then Doug, one of the Cath-Techs, said, “Tom, I think you’re going to like this.”; and the next thing I knew, I was impressed by how far the world of drugs had come. I was awake of course, but not quite “there”. The biggest side effect was that my nose itched. I asked ol’ Doug several times to scratch it for me. In what seemed like only 10 minutes or so, the doc leaned over and said it went“fabulous”. I told him I bet he told all his patients that. He smiled a warm smile and said, “In all seriousness, Tom… this is as good as it gets; a text-book, classroom procedure that was as good as I’ve ever done.” I smiled back as he left the lab to go tell my wife the good news.
After I came back from the Cath-Lab, a robust nurse named Terry came over to my bedside and introduced herself. She said, “Tom, this is pretty important. I’m going to have to take these sheaths, (long, plastic, guide tubes for the catheter), out of your leg. I want you to lie still while I do it. Then, I’m going to have to keep a hard pressure on it for about twenty minutes. You’re probably going to bruise from this, but it’s necessary.” I told her I was pretty good at enduring pain, and the fun began. True to her word, she put enormous pressure on my leg. I told her if she ever considered an alternative career, perhaps wrestling might be worthy of consideration. I watched her as she watched me, and we both glanced at the clock, counting down the minutes. Finally, it was past the required twenty. “Whew”, I thought, “what a relief”, (in more ways than one.)
That night was a long one. My beautiful wife stayed by my side deep into the night as we counted down the first critical hours. Thankfully, there was no bleeding and I knew I would be all right. My back was killing me from being flat and without movement, so a gracious nurse gave me a light shot of Demerol to ease my pain. By midnight, I could move again. What freedom… what release… I almost cried. Morning came slow and hard. It seemed like every time I looked at the clock it said the same thing, (“quit looking at me, or my hands will never move.”) So, that was the game I played, see how long I could keep from looking at the hands on the wall clock. I think the best I ever did was 6 minutes. It’s true what they say, “a watched clock never boils”; at least that one never did. As for as I was concerned, it was barely turned on. But, I made it. Through one of the longest nights of my life, I saw God’s holy light breaking through my window. I reflected that – several days ago I wouldn’t have bet a lot that I would ever see another beautiful desert sunrise.
You have to go without food for quite a long time before an angiogram, and that morning’s breakfast of barely warm scrambled eggs, and damp toast was pretty good. I’m sure I had smiles all over my face as various staff came by to see how I was doing. I nodded and smiled at everyone I saw. I wanted everyone to know how good it felt to be alive.
They discharged me that afternoon, and my wife took me home. My dog, Dillon, was practically levitating he was so glad to see me. As to the conclusion, -- well, as the Doc said, “You have no restrictions; go and enjoy life; do what you want to do; I’m sure you’ll find what’s right for you. One more thing, make an appointment with me in about 4 weeks, I want to see how you’re doing. Get out of here, lucky man.”
