Saturday, May 03, 2008


I've been holding off on talking about this one because it hit really close to home.

One of my good friends, an occasional shift partner at work, had an MI last week. Mickey (not his real name, of course), my frequent ADHD springboard, was working last Sunday on ALS-2 overnight when he started having symptoms: jaw pain, diaphoresis, nausea, with pale cool skin. Wings, his partner and the medic on the truck, got worried and assessed him. From what Wings (and Mickey) told me later, a 12-lead showed ST segment elevation in leads II, III, and aVF with appropriate reciprocal changes. Immediately Mickey got pulled off of his truck and placed on the supervisor's truck. Wings did all of the appropriate interventions: 325mg of baby aspirin, 0.4mg of sub-lingual Nitro, and IV fluids.

They got to the hospital and he was put in one of the back rooms initially, but he had a second episode of pain, diaphoresis, and dry heaving in front of Dr. Z, the attending doc. He immediately got pushed up to the head of the line when that all happened. Now my information gets a little fuzzy at this point because I don't totally remember the time line, but at some point not long after he went to Cardiac-1, he spontaneously went into a left bundle branch block. Wings was with him and he saw the activity happening, so he went out to the fishbowl (the nurses station) to let someone know what was going on. Well, it seems nobody was paying any attention to the alarms, so he went to the console, discovered the recorder was out of paper, reloaded it himself, and printed off the strip in real time. He then showed it to Dr. P (a George Clooney look-alike who in my opinion is a blithering idiot, but what do I know?) who looked at it and said, "hmmm... we should get another 12-lead, shouldn't we?" (No shit, sherlock...) So they did, and found that indeed it was an LBBB that was new onset. Within maybe 15 minutes of this, Mickey went to the Cath Lab.

The cardiologist did right by Mickey; turns out he had an occlusion of his right coronary artery plus minor blockages in some of his other coronary vessels. From what Mickey told me (and I saw both the pictures and the before/after 12-leads) it wasn't a big enough occlusion to warrant a stent, but he did get balloon angioplasty, which cleared the blockage out.

Mickey spent 2 days in the ICU and 2 more on the step-down unit before they turned him loose, and he's going to be out of work for at least the next 4 weeks. He's had to quit smoking and be taken off of Adderall to treat the ADHD symptoms. Also, he's been placed on a cardiac diet and is being made to take better care of himself. I have offered to take him to the gym with me once he gets cleared and work with him on an exercise program. Hopefully he will take me up on it.

A couple of things that are significant about this: first, he has a family history. Both of his parents have multiple stents in place, plus his father had a CVA at age 40. The scary thing? Mickey is 33. He is 13 years younger than me. And that puts a bit of fear into me, and motivation to continue to do the things I am doing to take care of myself.

I keep Mickey in my prayers as well as on my speed dial. I don't want to see him go through this again. If he gives me permission, I will post the pictures of his arteries at some point.

Until then, take care of yourselves.


Pete said...

That is scary, considering his age...I wonder how many 33 year old's (myself included 13 years ago) would have ingnored the initial symptoms (I'm too young to be having a heart attack), only to land up in far worse shape? I bet at 33, I might have been inclined to "sleep on it"...Glad to hear he got the necessary intervention and hopefully, with some lifestyle adjustments, will back at it again soon.
Although I'm in fair shape, I do have 3 risk factors for heart disease (pre hypertensive, high cholesterol and former smoker). I also have an unknown family history. I've become very sensitive to the ticker and it's function. I've been having bothersome arrythmias (palpitations) and am awaiting results of the Holter test..could be completely benign or evidence of a problem, but at age 46, I'm not waiting to find out. Interestingly, it's me that has to push the primary care doc to test beyond the 12 lead ekg....without other symptoms, he seemed rather indifferent - probably time for a new doc....
best to your friend - keep healthy.

AlexD said...


Believe it or not my best friend had a heart attack while he and I were working a code. Can you imagine the look on my face when he says, "Hey, Al...umm I think I am having a MI." He spent a month off of a truck but never fully recovered before he passed away. Like always, you have a great post. Keep up the good work.

Alex ~D~