Friday, January 4, 2013

The Nightmarish Miracles Before Christmas - Part 3

The morning sun brought with it hope.  Brian opened his eyes and turned his head in my direction.
"Hey... how are you feeling?" I asked.
"Better," he replied.  "Oh.  So much better than last night."  Hope surged.  "But I have this balloon pump thing in my aorta that is driving me crazy."  Yes... I thought, and couldn't help but smile.  I know... I'm sorry.  He had been groggily complaining of it throughout much of the night and, though I wished I could end his discomfort, it was so good to hear the complaint turn more coherent.  He put his hand on his chest, "it just keeps pumping and pumping, and it makes me feel all this weird pressure.  I hate it.  And my legs are stiff, and my back hurts, but they won't let me move."  Yes... you're talking!  "I wish I could sit up, or bend my leg."
"Can I get you some water?"
"Shhhhhh.... wait..." he pointed outside his room and turned his ear to where the doctor was talking to the team about Brian's case.  It made little sense to me, but Brian was interested.  After spending so many countless hours wearing his white coat and being involved in discussions just like that one, I imagine it was interesting for Brian to be the one in the robe and on the patient side of the doors. 

When they were done talking, the team crowded into the small room.  "How are you feeling this morning, Brian?" the doctor asked.  "Better," he responded.  "This balloon pump is really annoying, though."  The doctor assured him that they would take it out as soon as they felt they could.  After it was removed, if Brian could maintain his stable state for 6 hours, they would let him out of the ICU and put him in another room out on the floor.  The doctor applauded us on our quick action the night before in getting Brian into the emergency room.  "Your speed saved his life," he said.  "I really believe this was that serious.  Another half hour could have made the difference."  His tone was warm and reassuring, but the words chilled me.

Brian and I talked after that.  A real conversation that lifted my spirits more than anything else could have.  He told me his side of the story... how the pain had started as a funny pressure after he swallowed an Oreo bite.  How he thought the funny pressure was because the bite had gotten lodged in his throat at first, but how water didn't seem to help, and how the pain escalated so quickly while he sat on the rocking chair in the living room that after two minutes he knew something was quite wrong.  How he went to lay down on the bed to wait for it to pass.  But how just a couple of minutes later, the pain was becoming unbearable and had started spreading to his left arm.  That's when he called me to come.  It felt weird to be hearing his side of the story for the first time... I had been talking to so many people, relaying my side over and over and over.  I fought back tears as he talked; I couldn't help but feel so intensely grateful that I was hearing his side... I was all too aware that it was a side of the story that may have never been told. 

Oh, it was good to hear him talking.

Eventually, an ultrasound machine was wheeled into his room and they began their initial exam to find the extent of the damage. It was quite interesting to watch Brian's heartbeat on the monitor (but I still think my ultrasounds are more fun).

The echo showed that the very bottom portion of his heart (the apex) was not contracting.  This could be due, they said, to the muscle tissue still being 'stunned' from the heart attack or, the less desired option, to the muscle tissue being dead and turning to scar tissue.  They would know more after an MRI.  They measured the blood flow out of his heart and found it to be low.  Not terribly low... but low.  "EF of 45," they said.  EF?  45?  I was tired of asking for clarification, so waited until Brian and I were alone again and asked him what that meant.

In order to understand it well, a small understanding of the anatomy of the heart is helpful.  Your heart is divided into four different chambers, two smaller chambers on the top (called atrium), and two larger chambers on the bottom (called ventricles).  While each chamber is important, the left ventricle (called the powerhouse of the heart) is the chamber solely responsible for pumping the blood to your entire body.  When it contracts, the blood inside it's chamber is forced out through a large vessel (the aorta) and then is carried along hundreds of different branches and out to every muscle in your body.  I didn't realize before last week, however, that not all of the blood is expelled during each contraction.  The EF, ejection fraction, is a number that represents the percentage of blood that leaves the left ventricle during this contraction.  They call a heart 'normal' if it has an EF greater than 55... that is, if it pumps at least 55% of the blood it's holding out to the rest of the body each time it contracts. 

So Brian's EF of 45 was not great news.  But, it wasn't terrible either.  Plus, the hope remained that the muscle was just stunned and would regain its function.  After the echo, Brian asked me to go home and get some sleep.
"No way," was my response.  I was not about to leave him.  He was still laying in the ICU with a catheter tube shoved all the way from his groin to his heart, for heaven's sake, holding a balloon in his aorta that was steadily pumping because... well, I didn't know exactly why the balloon was in there or what it was doing, but I figured it must be important.  Plus, he had only been acting better for a couple of hours and I wasn't trusting enough to believe it wasn't a fluke.  No, I was much more comfortable sitting right there in that chair by his bed.
"Please, Linds," he pleaded.  "You need to take care of yourself right now, too.  I know you didn't sleep well last night," I didn't sleep at all, "and the kids are going to need you to be okay."  My eyes became teary again and I slowly shook my head.  "I'm not leaving you, Bri.  I can't."
"Please, Linds... I'm exhausted and want to sleep.  But I won't sleep well if I know you're sitting in that uncomfortable chair."  A tear dropped onto his sheet from my left eye and my eyebrows contracted in confusion.  "Really, I won't, Linds."  I knew he was right.  But I was also not sure I'd even be able to sleep, even if I was in my own bed. 
There were a few things I needed to do at home.....
"Okay, Bri.  But I'll only sleep for a couple of hours.  I'll be back soon."
"No, sleep for at least six."
"I'll be back soon."  It was a compromise, after all. When the nurse asked me for my cell phone number and wrote it down on the white board in Brian's room, my discomfort swelled.  She wanted to be able to get a hold of me quickly in case... anything changed.

I watched the road home through choking sobs.  Letting some of the anxiety and terror of the night before escape into the confined cab of my little Honda Civic was refreshing in a way, and by the time I pulled into the driveway I felt a little better.  I called a few people to give them updates and then spent an hour sorting through all the Christmas presents that had been stashed in my closet throughout the month.  I pulled them all out into the living room and started arranging them in piles.  A small pile of To McKenzie, From Mom and Dad, and another small pile To Carson.  Pile after pile after pile was assembled.  To Miles From Nana and Poppy, To Brian from Linds.  When all the piles were together I took a step back and felt overwhelmed.  Presents covered the floor, covered the couches and spilled into the dining room.  Amazing what a couple of presents to each kid from a few different sources can add up to... Four hours of wrapping, at least, stared me in the face. 

But an army of women were coming into my home that night, armed with scissors, tape, and wrapping paper to fight that battle for me.  All I had to do was label the piles so they knew what to write on the tags.  I took a shower and then snuggled down into my bed and let my mind tenderly trace the lines of gratitude that had formed over the last 15 hours.  The lines kept getting thicker, and it felt good and healing to spend some quiet time with them.  My husband was alive... friends were pouring out love... my feet were wrapped in brand new cozy socks... my house was magically clean from the party the night before; the rug back in place; the frosting wiped from every surface; the dishes done... my children were being cared for... and overnight, the piles of toys and clothes and games that I had arranged in my living room would be turned into shiny, wrapped presents.  Complete with bows and tags and ribbons....

I awoke two hours later and practically jumped out of bed.  Hospital.  Need to get back.  I rounded up a few things I'd missed the night before (sleeping pills being one of them (my camera being another)) and got to the ICU to find Brian's glass doors closed and a handwritten note taped to them that read: No Visitors.  Check with Nurse, please and thanks.  My heart stopped.  Had something gone wrong?  The nurse saw my face and rushed to reassure me, "This isn't for you, dear," she said.  "He's just been getting so many visitors today that it tired him out and he asked to be left alone to sleep."  Okay... that's okay.  A side effect, I guess, of having so many friends working in the hospital. 

At 4:30, soon after I arrived, the doctor agreed to stop giving Brian the intravenous blood thinner and said that, after it wore out of his system in about four hours, they would look into removing the balloon pump.  Brian watched the clock like a hawk for the next four hours and, as the time approached 8:30, he asked me to go remind the nurse that it was time and to ask if the pull doctor was ready.  Pull doctor!?  "Is that really the name of the doctor who is going to pull the catheter and balloon pump out through your leg?" I asked, amused.  Well, I suppose it makes sense...  To Brian's dismay, the pull doctor was running a little late and wouldn't be there until 9:00, half an hour after his scheduled time.  Brian took it like a champ, though, and when the doctor arrived at a quarter to nine, Brian felt he had received an early Christmas present. 
"Take a deep breath," the doctor said.  I wondered what it felt like as the doctor pulled the heart pump from Brian's heart all the way out through his leg.  "Weird," Brian told me later.  Once it was removed, Brian gave a sigh of relief and stayed still for another 15 minutes while the doctor applied pressure to the punctured artery.  (Really... 15 minutes.  It was a long time.)  Brian remembers the 15 minutes of applied pressure as his job when he was rotating through the cardiac ICU.
"If you feel any warmth or wetness down here at any time through the night, make sure to let the nurse know," the doctor said before he left.  "That means you're bleeding and we need to get it taken care of quickly."  Yes, you don't want a major artery bleeding for long...  The doctor left, and groin checks started every fifteen minutes afterwards for the next hour, every 30 minutes for the hour after, and then once an hour for a remaining two.  Brian didn't love those.  But he did love being able to bend his leg.  

Meanwhile, angels were at work in my home.  It warmed me when Amy texted these pictures to me later that night. 

The rest of the night was ... what word can I use?  I could just say better... that would be true... but it doesn't give quite the right feeling.  Because it was still quite terrible.  In comparing it to the night before, it was better... but in comparing it to regular nights spent snuggling with Brian and sleeping in my own bed with no life-threatening concerns lingering in my mind, it was devastatingly despairing.  There were more complaints of pain, more medicine adjustments, more tense facial expressions from the nurse and doctor.  I did sleep better, though.  Probably because of the sleeping pill.  Or because I didn't have quite so much adrenaline running through my body.  Or because I was already so sleep deprived in the first place. 

Whatever the reason, I was happy to wake up on Christmas Eve knowing I had spent much of the night in sleep.  And knowing that if all went well that day, Brian would have an MRI, we would have more answers, and he would be moved out of the ICU onto the regular floor.  Into his own room.

A room we could bring the children into.  A room that would see us all together as a family.  A room in which we would celebrate Christmas.


  1. I am so happy Brian is definitely seems as though there were miracles all along the way to make sure of it. And I must say, I am on the edge of my seat reading through every post. It's quite fascinating for someone in the medical field:)

  2. I get so choked up. You two are amazing. The Lord tests you and you shine through triumphantly. By the way you explain anatomy and medical conditions really well. I know that is not the most important thing right now, but I am impressed.

  3. I love to see all of the ways that people saw that you needed help & met those needs. Gives me hope that one day I'll be able to help that well...

  4. Ditto to everything posted in the comments above. love ya

  5. I am constantly humbled to have you as a friend. I love you and miss you so much. So glad that there was an army of angels there to help you. Give your sweet family a hug from "Jellie".

  6. Lindsay, I just read through some of your blog from the events surrounding Brian's heart attack. It must have been a surreal event for a young family with a 32 year old husband. Your writing style is amazing and your ability to express detail and nuance of thought and feeling is extraordinary. Your writing is clearly a gift from God. Thank you for sharing this. I also loved your family Christmas letter. It was so refreshing in this world of Christmas letters that are "Pinterest perfect". Brian is a great blessing to the medical community here. I have complete confidence in his abilities to communicate and reassure patients as well as his excellent medical/surgical skills. You and Brian and your family will have continue to have an important role in blessing many in the Las Vegas valley. I hope you had a great Christmas season. God bless you in abundance.