Brigitte’s Amazing Big Adventure (BABA)

January 4, 2009 No Comment

On the morning of Sunday the 27th of March, 2004, we were in South Lake Tahoe for a weekend of snowshoeing. We selected a route to an area known as “Big Meadow”. It involved an ascent of perhaps 400 vertical feet to reach the meadow. It was a lovely day with temperatures in the 50’s but the winds were pretty forceful higher up. We saw a wonderful meteorological phenomenon called a Sun Dog (kind of a rainbow around the sun) on the way up. Perhaps halfway up, Brigitte began to feel uncomfortably warm and short of breath. Neither of us thought that terribly significant as the altitude was about 7000’ and it was somewhat strenuous climb.

I made it to the meadow around 11:30 but discovered winds gusting to 50 Mph. I came back down and suggested to Brigitte that we descend. She readily agreed. She complained at that point of some tightness in her chest. We returned to the car and went back to our hotel in Stateline for lunch and a rest. After an hour’s nap, we awoke and decided to go for a walk to help ourselves feel better. During the walk it became clear that Brigitte was in some distress as she couldn’t catch her breath while walking on the flat. She also mentioned radial pain down her arms for the first time.

As we returned to the hotel very slowly, I became aware that things were not normal and insisted that we call Kaiser. After conferring with the advice nurse for perhaps 3 minutes, Brigitte handed me the phone and the nurse simply said “Call 911”. Always the good student, I did as I was told.

(Oddity 1) At least I tried to. Picking up the phone in the motel, I followed the directions and dialed 9, then 911. I kept getting a busy signal. Not a good sign. As time was precious, I went down the veranda to the manager’s office and knocked. “I think my wife is having a heart attack and I can’t seem to dalI 911 from the room phone.” I said, trying to be concise but not too alarming. From the look on her face, I thought we might need two ambulances. However, she recovered, got her own phone and called 911 for me.

Within 2 minutes, there was a crew of 4 paramedics/nurses in the room. They loaded her up and into the waiting ambulance. After taking her vital signs and administering Aspirin and Nitroglycerin, she was transported toBarton Hospital in South Lake Tahoe.

At Barton we first became aware that it really was a heart attack after some blood work came back. The staff was very attentive and supportive. A nurse joked that Brigitte had definitely flunked the stress test (snowshoeing) and passed the nitroglycerin test. Up to this point, I’d felt reasonably calm. However, when I phoned our oldest son Joshua, I found it very hard to tell him what happened and broke down a bit.

Once it became clear that treatment could not continue at Barton due to its small size and other limitations, arrangements were made to have a LifeFlight helicopter brought in to take her to Washoe Medical Center in Reno, NV. As before, the weather played a part. The helicopter had made it to the hospital but the winds began to gust over 40 knots. It was decided that Brigitte needed treatment immediately and that they would send the LifeFlight crew in a regular ambulance, much to her relief. She wasn’t too thrilled about a helicopter ride at that point.

I said goodbye to her and suggested that she tell some jokes on the way, perhaps to feign confidence that I wasn’t sure I had at that point. As they were headed up to Reno, I returned to our hotel to collect our belongings as it was pretty clear that we’d be in Reno for sometime. After checking out of the motel, I headed to Reno. It was perhaps the most harrowing drive of my life. I was concerned about my life partner and the weather just kept getting worse. The first half of the trip was in a blinding snowstorm with winds gusting to 40 mph. It got a bit easier as I descended down the mountain into Carson City, NV as the snow turned into rain.

In Reno, Brigitte arrived and was taken to the Cardiac Catheterization Lab. The Doctors assumed that her’s was a normal heart attack associated with heart disease; they performed an angiogram which used a catheter to search the arteries for plaque deposits, blockages and other abnormalities. They were surprised when they didn’t find any. She has no evidence of CAD (Coronary Artery Disease). By this time, it was near 10 in the evening and I had finally found where she was. Her doctor explained what had occurred and that he had no good explanation for why she had an attack, other to suggest that perhaps she had a blot clot at the time of the attack and that with all of the blood-thinning medications she was given that evening, it may have dissolved on its own. I went to her bed in the Cardiac Intensive Care unit and kissed her goodnight.

[Oddity 2] I left the hospital to look for a hotel room. I had seen a Motel 6 sign on the way in and that seemed like a good bet. I just needed a place to sleep for a few hours. I found it and went into the office. I managed to secure a room but the exchange with the clerk was odd. I couldn’t put my finger on it. I had told her that I needed a room as my wife was in the hospital near by. She mumbled something like “Yeah, right. “, but I just figured that I was very tired and very stressed. I found my room, undressed and fell into bed. Shortly, it began to get loud in the parking lot. Cars were coming and going, doors being slammed and loud conversations ensued. Some of those conversations could be termed “trash-talking”. From time-to-time, someone, or perhaps several someones walked heavily across the second floor walkway. I imagined German Storm Troopers. In any event, this went on until perhaps 4am. I checked out early the next morning (Monday), got some breakfast and headed for the hospital. As I related my experience to Brigitte, the woman in the next bed chimed in. “I couldn’t help but overhear, dear. I used to work in the Sexually Transmitted Disease section of the county health department. That Motel 6 is widely know as a prostitution hangout.” Oh. Well. That explains a lot.

Shortly thereafter, we were visited by the doctor who would become her primary doctor, Cardiologist Dr. Richard Seher. He explained a number of things. First, they had noticed a rare condition called a Myocardial Bridge. This is a growth of heart muscle tissue over the top of one of the arteries supplying the heart. With each beat of her heart, this muscle collapsed the artery restricting blood flow to the heart. It was perhaps 1/3 of the way down the left descending lateral artery, the main supply of blood to the heart.

It was theorized that this may have been where the clot lodged as the damage to the heart was below this area. Brigitte was looking pretty good at this point and neither of us were prepared for what he said next. “This was a major heart attack, perhaps 8 or 9 on a scale of 10”. Dumbfounded, I asked what the treatment was. He said that on the following day, one of his associates would use that same catheter process to insert a stent (a small device, something like a ball point pen spring) into the artery to keep it from collapsing again.

[Oddity 3] I left the hospital to look for another hotel room. This time, it seemed a good idea to find a better class of hotel. Since it was still light outside, I thought that the Holiday Inn looked pretty nice. I checked in and the hotel offered me a special rate as a deal with the hospital. My room was behind the elevator shaft, but I was pleased to find that I could hardly hear it. That brief euphoria would soon go away… A group of High School Future Farmers of America from Elko County checked in that evening and essentially occupied the entire 6th floor of the hotel. Did I mention that my room was on the 6th floor too? I’m guessing that the adult advisors spent a great deal of time in the casino since the kids appeared (and sounded like) they were entirely unsupervised. I’m guessing that they were playing a form of hallway basketball or floor hockey most of the night. Out came the earplugs as the front desk was unable to keep them quiet for more than a couple of minutes. Not much sleep this night.

On Tuesday, the procedure was performed by Dr. Carl Juneau. Two stents were inserted to keep the artery open. Following the procedure, Dr. Juneau invited me back to his lab where he showed me x-ray movies of before and after. The difference was astonishing. We were given copies of the video to share with the Kaiser physicians. Brigitte returned to the Cardiac Intensive Care unit and was resting well throughout the afternoon, though in some pain at the site of the catheter insertion on her right wrist. I went back to my hotel after dinner. Later in the evening, Brigitte had a crisis. She began to feel slightly nauseous and then faint. Before she knew it, there were people in the room ready to revive her because the monitors showed her blood pressure was taking a severe dive. Adhesive defribulation panels were applied to her chest and back. They injected her with Aphedrine Sulfate to stimulate the heart. Normally, this is done to people who have already lost consciousness. Brigitte was awake however. The injection burned her left hand so intensely that she screamed. This may have helped her heart get going again, who knows?

The rest of the evening passed uneventfully and I did not know of this until morning. Brigitte chose not to have me informed. She didn’t want to alarm me. It was probably a wise decision on her part as I wasn’t sleeping all that well to begin with. Over the next couple of days, Brigitte began to look much better. She remarked that she even felt able to breathe better than she had for several years.

[Oddity 4J See Oddity 3. Not much sleep this night either.

Slowly, things started to fall in place. We began to think back over the last several years and realized that she had experienced a slow decline in her energy levels and ability to participate in life in spite of a healthful diet, regular exercise and good medical care. Perhaps this condition had been affecting her life for some time, slowly at first, a crisis at the last. On the positive side, she’s less cold, is able to breathe more deeply and hasn’t looked as good in some time. She’s made plans to take the month of April off from work at the County. We saw her doctor at Kaiser Monday afternoon. She will be referred to a Kaiser Cardiologist in the next few days.

Throughout the adventure we’ve marveled at the advances in medical technology and knowledge. I was very thankful to have my Blackberry, a cellphone/PDA that kept us in touch with all.

A MasterCard moment

• Hotel room with a phone that won’t dial 911: $62

• LifeFlight Helicopter crew for the ride to Reno: $7,380

• Motel 6 room with external “entertainment”: $34

• Keeping my best friend alive: Priceless

We feel blessed, loved and supported by our companions. We’re deeply grateful for your loving thoughts and wishes