When Delay Can Cost You Your Life

People make poor decisions about when to call their physicians when they are faced with new or worsening symptoms regardless of their level of education.  I came close to making a similar mistake about 8 years ago that could have cost me my life.

It was early in the Fall of 2003 when I started having symptoms of an aching pain in my left shoulder.  It would come and go, and I thought it was due to some sort of musculoskeletal strain of that shoulder or referred pain from a neck problem.  I started noticing it would occur when I was walking or doing other exercise.  My wife & I were on vacation, and during a round of golf I noticed it when I had to walk across the fairway to my ball.  Again, though in the back of my mind I thought it could be my heart, I denied that possibility.  I thought it was due to the fact I hadn’t swung a golf club in years.  What made me face the possibility of something more serious occurred about a week later.  When my wife & I were walking our dog on a Sunday evening it became clear that the pain was brought on by walking.  Adding to my concern and suspicions of something more ominous was an accompanying profound tiredness and shortness of breath relieved by rest.  I called my primary care physician the next morning.  He suggested I call a cardiologist since I would probably need a stress test or possibly a cardiac catheterization.  I immediately called one of the cardiologists I knew, and he scheduled a stress test for me the next day.

The next day I had the stress test with an accompanying echocardiogram.  The echocardiogram shows how the different portions of the heart are functioning under the stress of exercise.  As I was exercising that left shoulder discomfort began and persisted throughout the rest of the test.  My cardiologist was there the whole time and said the EKG (elctrocardiograph) portion of the test looked good, but he had some questions about what the echocardiogram was showing.  He was going to speak with one of his partners about it.  He wanted me to get dressed and would see me in the exam room.  I changed back to street clothes, and went to an exam room.  There the nurse checked my blood pressure and found it to be a bit low, so she had me lay down.  My doctor soon came in and said he wanted to do a cardiac catheterization that day to determine why one of the walls of the heart was not moving normally.  (When your coronary arteries are blocked, certain areas of the heart wall don’t get enough oxygen-carrying blood and will move abnormally.)  Of course I agreed, but wanted him tell my wife, Mary.  She soon joined us, and as he started to tell her, everything went black and I had a cardiac arrest.

They made three attempts at electrical defibrillation before finally bringing me back with the fourth. The first thing I remember is a nurse lifting the oxygen mask from my face and asking, “Are you back with us?”  I guess I still had my sense of humor because I replied, “I didn’t know I had left.”  Everyone was relieved and all the staff involved with my resuscitation laughed.  Mary, who was waiting in the hall, heard the laughter and started to breathe a little easier.

My point in relating my experience was to show how even a doctor who deals with these signs and symptoms every day with his patients can be in denial about his own situation. If not for my finally facing my symptoms objectively and the good fortune of having the cardiac arrest in the absolutely best place, I probably would not be writing these words.  It’s better to be overly cautious about new or worsening symptoms.  Let your doctor assess them, because they can deteriorate in an instant.

In future posts I’ll share more of my experiences with the health care system.   I’ll talk about surviving two hospitalizations and making lifestyle changes to prevent another heart attack.  In the next one I’ll give some pointers about how to handle new and worsening symptoms.

For Your Health – Dr. Bob