25, 2013, José Luis Díaz was born again. And he sent me his story, which is one of the most
entertaining, dramatic and well-read post of this blog and which I invite you
to re read: Return to tell it. Report of a HEART ATTACK.
He is still making trouble (especially for the extension of his post, which
although I warned, I refuse to mutilate), and he sends me his firm candidacy to
the blog with his post: After overcoming an infarction.
hospitalization lasted only five days. The first one could be deducted because,
on having recovered the conscience, it had practically faded away. The four
remaining ones became longer than usual, simply for being in hospital.
they were the best days of my life wouldn’t be
true, however, and to my surprise they were much better that those which
were to come.
The first day: As I have already said it turned out to be the shortest day of
my life, since I “returned” between 18 and 19 o’clock and, therefore,
the day was left already a few hours, nevertheless, I had the FIRST JOY, I had
returned and continued HERE; tubed, but HERE; disoriented, but HERE; in
discomfort, but HERE; aching, but HERE; sounded and with more tracts (Tracks) than
the Railway station of Chamartín, but HERE. Fuck! (my
apologies), despite how badly I was and how happy I was to be HERE.
day: In the first hour TWO more HAPPY MOMENTS for the price of one. One of the
first people to come to you is the
doctor. And the first thing that he does is to ask you how you are and if you
know what happened to you. You respond that you think you have suffered a heart
attack and he confirmed that it was so and congratulates you for having
overcome it, using the expression “CONGRATULATIONS, YOU WERE BORN AGAIN” and
you think “that must have been really serious”.
good-bye to the tubes ( a relief) and the family visits you rather emotioned
and you find out that they were there the day before, although you weren’t
conscious at all and you get also emotional and therefore, and because you are
free from tubes, you find it difficult to swallow.
day: THREE MORE JOYFUL MOMENTS, just to keep it balanced. Washing
dry with soapy sponge, removal of the femoral route and transfer to ward, where
you change from being alone to have a partner who is also an expert in
cardiovascular disease after multiple entries, defibrillator implanted and
familiar with medical personnel, for his repeated and long stays. Greater
number of visits and, as a result , the pains become annoyances.
day: food, with hardly any salt, is a small disappointment and, although first
lunch and dinner are returned virtually intact the way they have come, the return of appetite and
lack of alternatives make the following more bearable.
fifth day: hospital discharge. Although it became effective at the last minute,
the DISCHARGE. But before: The ‘recommendations’
in salt and in cholesterol (eggs, whole milk and derivatives, pork and sausages
and other fats of animal origin) and rich in fish, especially the blue ones,
fruits, vegetables and pulses.
REFRAIN FROM SMOKING.
keep a quiet life after discharge avoiding
LISINOPRIL, CARVEDILOL, add, PLAVIX, more CARVEDILOL and CARDIL and, if you
have pain, ACETAMINOPHEN.
presenting thoracic pain again, take a tablet of sublingual nitroglycerin
(VERNIES), sitting or lying, and phone 112.
need to start exercising little by little, in a progressive way, until you see
if you manage to walk for one hour a day. Control by their primary care
physician. Please perform analytical with blood lipid profile, glycosylated
hemoglobin and ferrocinetico profile. You will attend the Day Hospital of Cardiology
for the realization of therapeutic coronary angiography. You should come in
fasting and with a companion.
them, finally HOME! . HOME, SWEET HOME.
arrive home you see everything in a different way, familiar but different. And
once in your favorite chair, which, incidentally, has been so grateful for your
absence these days, you will reread the report of hospital discharge.
Current history (…)
Physical examination (…)
Complementary tests (…)
DIAGNOSTIC TRIAL (…)
begin to order medication, recently arrived from the pharmacy, to be able to
comply with dosage and the times indicated (1. Omeprazole, 2. Lisinopril, 3.
Carvedilol, 4. Add, 5. Plavix, 1 bis. Carvedilol and 6. Cardil). After that you
restart again the hospital discharge report and try to understand something
else, while, with imagination, you try to translate acronyms dotted around it.
Code AMI: Acute myocardial infarction (I guess).
Arriving at the hospital, directly to HAS:?
With a multitude of FV: Ventricular fibrillation (I guess).
The total time of CRP: Cardio Respiratory Stop (I gather).
Electrocardiogram to income: SR 90 bpm, with normal PR, narrow QRS complex. At
bottom, side and face precordial ST-Elevation:?
ECG at discharge: SR 80 bpm, with normal PR, narrow QRS complex. On left side,
inferior bypass ST elevation. Negative T in inferior side:?
coronary angiography: 3-vessel coronary disease. Interventionism. The distal
Guide RC is re-routed and thrombotic manual aspiration is performed on multiple
occasions obtaining abundant thrombotic material. Electively a stent 4.0×26 is
implanted in the distal RC zotarolimus-coated, after which it turns to suck on
branch posterolateral and IVP, getting final flow TIMI2. Femoral AngioSeal
closure without complications: with good will and imagination: the right
coronary artery was to be completely blocked and other two arteries partially.
After vacuuming clots that caused the first obstruction, a medicalized stent is
placed and they aspire around again.
Echocardiogram: left ventricle not dilated, with normal parietal thickness. Lower
Akinesia (with its basal third dyskinesia), lateralinferior, a distal third of
side and lower septal. Akinesia of the apical and distal third in anterior
septum and previous
depressed global systolic function (LVEF 40%, at the expense of hyperkinesia
compensating the rest of segments). Transmitral
filling pattern consistent with alteration of the relaxation. Non dilated left
atrium. Right Ventricle non-dilated, with normal global systolic function. Morphologically
normal mitral valve. Minimum insufficiency. Morphologically and functionally
normal aortic valve. Tricuspid Valve morphologically and functionally normal.
Systolic pressure in pulmonary arterial not estimable. Inferior vena cava dilated with inspiratory
collapse less than 5%. No pericardial effusion. Not dilated aortic root. Normal
ascending aorta (29mm): In this case, not even with good will. After learning
all about it thoroughly I can already say that
KNOW THAT I KNOW NOTHING
if we add to my confessed ignorance that the discomfort I felt in chest and
back, which had almost disappeared as a result of the brief hospitalization and
quick return home, they come back again; that at bedtime you feel difficulty
breathing; on the bedside table, close at hand, lie the sublingual
nitroglycerin tablets and that among the few things that have become clear is
that you have a “3-vessel coronary disease”, the possibility that the
pain in the chest and the dreaded INFARCTION may happen again come to occupy a
special place in your thoughts.
convinced that the report is a useful tool to keep the relevant data of the
“happening” and its successful treatment. It is also useful,
undoubtedly, for other medical professionals to learn what happened and to act
accordingly and may even be a very valuable instrument to avoid
responsibilities if the purpose, by all pursued, would not be achieved despite
the efforts made by the professionals who looked after me; but what is also
undeniable is that this little or nothing brings to the sick.
patient is really interested in and
worries about is to know HOW SERIOUS HIS/HER ILLNESS IS, how high is the
RISK THAT THE INFARCTION COULD RECUR even observing the medical prescriptions,
how damaged are the coronary arteries and, consequently, WHAT FUNCTIONAL
LIMITATIONS IS GOING TO HAVE , which things CAN or MUST DO and CANNOT or MUST
NOT DO and all those QUESTIONS that, RELEVANT as they may be, from the ignorance in the matter
turn out to be impossible to ask.
of information is alleviated to some extent by the information that patients
receive during the cardiac rehabilitation programs, but in my humble opinion,
many occasions, has been scared and if he managed to get to sleep at night and
be more or less well during the day in the weeks immediately after the event,
has been thanks to tranquilizers and anxiolytics.
so complicated to deliver the patient,
along with the current medical report, a more intelligible report?
I propose to any of the medical professionals that could read these lines, to
make the effort of translating terms and technical expressions which have been
reproduced to make them affordable to
those who, like me, only know about the heart in what is said in the gossip
magazines and when you suffer a disappointment
in love you come to have a “broken heart” I am sure that in this way they will
be contributing to humanize the intensive care.
very much for your patience and interest.
you something to think about.
A hug crack!