ImageNo, no - it's nothing political this time (although the title might suggest it). I thought my readers could benefit from two accounts of female heart attacks that came across my desk. My sister wrote the first one (about our other sister). I don't know the author of the second account, but it certainly rings true. Both stories reminded me of my own memorable weekend in the hospital, a year ago. (It wasn't a heart attack, in my case, but it was bad enough.)

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Nurse's Heart Attack Experience 

This is not totally gender specific. Women and men can show any of these signs. The medical profession has finally recognized, however, that women can have Myocardial Infarction (MI) symptoms different from those experienced by men.  

In 1996, my sister had a bad infection that causes clumping of the platelets. We didn't realize, until later, that this blocked some vessels in the back of her heart. She had two primary symptoms.  One was loss of appetite. I had made pork chops and scalloped potatoes for dinner - a favorite meal - but she couldn't eat it.  (We decided later that if we can't eat, we call 911, pronto.)  The other symptom was a sensation like a toddler standing on her sternum.

She finally decided that it would be way too embarrassing to have an article in the paper about an emergency room nurse found dead in her home from a heart attack. So after updating her medical history on the computer the next morning, she drove herself to the ER.  In the parking lot she happened to meet a doctor that she knew from Children's Hospital. He probably saved her life.

She went to the ER, where they diagnosed her with indigestion, reasoning that (a) she was too young for a heart attack, at 45, and (b) she didn't have the classic symptoms (chest pain, pain radiating down her left arm, etc). They let her sit for FOUR HOURS without proper diagnosis or treatment until her doctor friend came over and bullied them into doing the blood tests that showed she was having a heart attack.  She spent the next two weeks in the coronary care unit.

I've since seen TV spots and read stuff indicating that ERs now realize that when an overweight, middle-aged woman comes into the hospital with chest pressure, she's (a) not a hypochondriac, (b) not imagining things, or (c) not automatically to be dismissed.  It's about time.

The lessons we learned from this and other ER disasters:

1.      Never walk into an ER if you don't have a visible injury like a bone actually poking through the skin. Call an ambulance. ER-staff figure that if you can walk, you're not sick. If you're in pain and walk in, you're probably drug-seeking.

2.      Never be a middle-aged, overweight woman in pain.  It can be fatal.

3.      Always have a medical history updated and readily available. With the tiny computer drives that they have now, you can attach a data-stick on your key-chain.  Or keep the history in your purse. The history should contain the following:

  • A complete list of all meds you take, including supplements and OTC stuff. Divide the list into sections for Rx meds, supplements, and OTCproducts. This is crucial. If you take a lot of meds, there's no way you'll remember them all when you're in pain andthey're trying to get a history. It's easier and more accurate to hand them a piece of paper. (This also comes in handy for emergencies other than heart attacks.)

  • Your name and address.

  • A list of your medical professionals.

  • A list of your current medical problems.

  • A complete medical history. (Year and condition diagnosed or treated is sufficient.)

  • A description of any weird things. For example, I had a rather unusual kind of weight loss surgery done out of the country. I carry a printed diagram of the surgery, along with my surgeon's discharge letter describing the surgery, in my wallet. Ialso note that I have knee replacements.

We both keep this information updated.  Believe me, when some poor sleep-deprived ER-resident is trying to evaluate you, his relief is evident when he holds a list of meds and a diagram explaining that mysterious scar down your middle. I have lain on a bed, surrounded by residents and interns poring over that diagram as if it were one of the Dead Sea Scrolls.

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The Total Surprise Heart Attack

Women rarely have the same dramatic symptoms that men have when experiencing a heart attack - i.e., the sudden stabbing pain in the chest, the cold sweat, grabbing the chest and falling to the floor, like we see in the movies. Here is the story of one woman's experience with a heart attack.

I had a heart attack at about 10:30 PM, having had NO prior exertion, and NO emotional trauma that could have brought it on. I was sitting all snug and warm in my chair, on a cold evening, with my purring cat in my lap, reading an interesting story my friend had sent me.

Suddenly, I felt that awful sensation of indigestion - like when you've been in a hurry, grabbed a bite of sandwich, and washed it down with a dash of water. You feel like you've swallowed a golf ball, and it's going down the esophagus in slow motion. It's most uncomfortable. You know you should have chewed more thoroughly and drunk a glass of water to wash it down. This was my initial sensation. Trouble was, I hadn't taken a bite of anything since about 5:00 p.m.

After the "indigestion" subsided, the next sensation was like little squeezings coming up my SPINE (hind-sight: it was probably my aorta spasming) - gaining speed as they continued racing up and under my sternum (the breast bone, where one presses rhythmically when administering CPR). This fascinating feeling continued on into my throat and branched out into both jaws.

Aha!! Now I stopped wondering what was happening. Haven't we all read and/or heard about pain in the jaws being one of the signals of an MI? I said aloud to myself and to the cat, "Dear God, I think I'm having a heart attack!"

I lowered the footrest, dumping the cat from my lap, started to take a step, and fell on the floor instead. I thought to myself, "If this is a heart attack, I shouldn't be walking into the next room where the phone is, or anywhere else - but, on the other hand, if I don't, nobody will know that I need help. And if I wait any longer I may not be able to get up at all."

I pulled myself up and walked slowly into the next room and dialed the Paramedics. I told the girl I thought I was having a heart attack because of the pressure building under the sternum and radiating into my jaws. I didn't feel hysterical or afraid - just stating the facts. She said she was sending the Paramedics over immediately, asked if the front door was near to me, and if so, to unbolt the door and then lie down on the floor where they could see me when they came in.

I unlocked the door and then lay down on the floor, as instructed. I must have lost consciousness, as I don't remember the medics coming in, their examination, them lifting me onto a gurney or getting me into their ambulance. I didn't hear the call they made to St. Jude ER, on the way. But I did briefly awaken when we arrived. The cardiologist was there in his surgical blues and cap, helping the medics pull my stretcher out of the ambulance. He was bending over me, asking questions ("Have you taken any medications?"), but my mind couldn't interpret what he was saying or form an answer. I nodded off again, not waking up until the cardiologist and his partner had already threaded the teeny angiogram balloon up my femoral artery, into the aorta and into my heart. They also installed two side-by-side stents to hold open my right coronary artery.

It might sound like all my thinking and actions at home must have taken at least 20-30 minutes before I called the paramedics, but it was only 4-5 minutes. Fortunately, both the fire station and St. Jude's are only minutes away from my home. My Cardiologist was all ready to go into the OR and get going on restarting my heart (which had stopped somewhere between my arrival and the procedure) and installing the stents. All this happened very quickly.

Why have I written all of this with so much detail? Because I want others to know what I learned, first hand. It might save someone:

1.      Be aware when something different is happening in your body - not necessarily the classic men's symptoms, but inexplicable things, like my symptoms. It is said that many more women than men die of their first (and last) MI because they didn't know they were having one, and they commonly mistake it for indigestion. They take Maalox or other anti-heartburn med and go to bed, hoping they'll feel better in the morning when they wake up - which never happens. My female friends, your symptoms might not be exactly like mine, so I advise you to call the Paramedics if ANYTHING unpleasant is happening that you haven't felt before. (Pain in the jaw can wake you from a sound sleep.) It's better to have a 'false alarm' visit to the hospital than to risk your life guessing what it might be!

2.      Time is of the essence. If you can take an aspirin, do so. Do NOT try to drive yourself to the ER. You are a hazard to others on the road. Do NOT have your panicked husband drive you - who will be speeding and looking anxiously at what's happening with you instead of the road. Do NOT call your doctor - he doesn't know where you live. If it's night, you won't reach him anyway; if it's daytime, his assistants (or answering service) will tell you to call the Paramedics. Also, he doesn't carry the equipment in his car that can save you. The medics do - especially, OXYGEN that you need ASAP. (Your doctor will be notified later.)

3.      Don't assume it couldn't be a heart attack because you have a normal cholesterol count. Research has shown that an elevated cholesterol reading is rarely responsible (unless it's unbelievably high and/or accompanied by high blood pressure). MIs are usually caused by long-term stress and inflammation in the body, which dumps all sorts of deadly hormones into your system to sludge things up in there. Be careful and be aware. The more you know, the better chance you have of surviving.