My story.

I've seen fire and I've seen rain

I've seen sunny days that I thought would never end

I've seen lonely times when I could not find a friend

But I always thought that I'd see you again...

--James Taylor, "Fire and Rain," 1970

I don't know the mechanisms behind grief.  I don't pretend to understand it, and don't really know why there are some things that I have been able to let go and some that I have not.  Everyone has their story, and if you get nothing else out of this blog, please take this.  It can and DOES happen every day, and the saddest part of it is that this is highly preventable.  It could be happening to your grandparents, your parents, or even you...and it is sometimes silent right up until the end.  

On March 26, 1966, my paternal grandfather was on a hike with his Boy Scout troop when he collapsed, presumably from a massive heart attack, in the presence of his 11 year old son (my uncle).  That is about as much as I know about this particular incident, since it was rarely discussed by the time I was old enough to understand it.

He died at the age of 41.  I never knew him.

Fast forward 40 years.

In January of 2006 I was living with my father in his townhouse.  My parents had split in 1994 and after my high school graduation I moved in with him so I could attend Illinois Central College.  After two and a half years of not knowing why I was still going, I took a full time position in the customer service department of the Peoria Journal Star, where I was already working part time.  Life was looking up; I had a new car, a “new” job, health insurance, and was looking forward to finding my own place later on that year.  

One nasty Friday night during that January, the snow was falling faster than the city could plow and salt the roads, and driving was treacherous.  We were on our way back from his longtime girlfriend’s house in separate cars and he followed me home, staying close behind in case something were to happen.  I remember one large SUV came flying up around us and it looked like he was going to cut in between our cars, so my dad sped up faster than he should have to keep the truck from cutting in.  I remember him saying afterward, “You can f--- with me, but you don’t f--- with my family.”  It was a quote I never forgot for some reason, spoken in his usual crass manner.  It still is significant to me today, possibly because now I realize this was the last time I ever saw him well.

The next day he came down with a bout of the stomach flu.  This was rare for him; I hardly ever saw him with even a cold.  I shook it off at the time, and by Monday he seemed to be feeling a little better.  We ate at the Golden Corral buffet there in town, but he still wasn’t eating his usual amount of food.  I found this to be a little odd but probably sensible for someone still recovering from a stomach bug.  He complained of continuous indigestion and was not comfortable in any position.  I didn’t know why at the time, but it bothered me.

By Thursday, however, it seemed to have taken a turn for the worse.  When I arrived home from work around 1:30 in the afternoon, he was home already.  I walked in the back door and he was nowhere to be found.  Worried, I went upstairs only to find him in bed, reading a book.

His nausea had returned, and he told me he kept dozing off at his desk at work.  Something wasn’t sitting right with me about this, but I couldn’t put my finger on it at the time.  I went on to Bunco Night with some co-workers, but I couldn’t get my mind off my dad and his strange illness.  I believe he slept in the armchair that night.

On Friday night he still was feeling no better, and he asked me to take him to the emergency room.  I drove him in his car since he told me he was feeling too weak to drive.  Upon arrival at the ER, he told the registrar about his symptoms and that he thought he had the flu.  A flurry of doctors and nurses came through. Respirations, blood pressure, and pulse oximetry was taken, and though I don’t know the results (I do remember his O₂ levels being around 88-89%) the question afterward came, “Have you ever had an EKG?”

Most of the details of that night escape me now, but I remember the most important points.  Oxygen was applied, a 12-lead EKG was done, blood tests were drawn, and finally around 10:00 P.M. one of the doctors came in.

“You had a heart attack.” 

As often as those words are spoken by doctors every day, they’ve become almost a staple in our society.  We all know that heart disease is the number one killer of adults in the United States.  That alone is saddening, but what saddens me more is how little this statistic is taken seriously by the general public.

The days afterward are very much a blur.  He was admitted to Methodist’s Cardiovascular ICU and after he was settled in, I drove home so I could get some rest and come back the next morning.  My father was scheduled for an angiogram that morning and the results were grave: two major coronary arteries (the RCA at its origin and LAD distally) were completely blocked. Another, the left main coronary artery, was 95% blocked. Also, two others were severe enough to need coronary artery bypass grafts (or CABG).  

Anyone that is familiar enough with heart failure will understand what I mean when I say his ejection fraction was between 5-10%; for anyone else, much of his heart muscle had already died.  The cardiologist, Dr. Radee, inserted an intra-aortic balloon pump to help my dad's heart keep pushing blood through his body, and in a nutshell my dad was told that without CABG surgery he would probably die.  The surgery was scheduled for 7:30 the next morning.

I can’t even begin to explain what I was feeling.  Most of it was numbness.  This couldn’t be happening, this was my father, and he couldn’t die…this had to be a nightmare from which I would soon wake up.  It had to be.  We were too close for him to be taken away from me.  When I watched my father wheeled away to the OR I kept telling myself, It’s going to be fine…we’ll get through this just like we’ve gotten through everything else, we have to...it’s all we can do.  

Eight hours later my dad was finally out of surgery and in recovery.  The heart surgeon, Dr. Dale Geiss, came out and spoke with my family, some of which had come from out of town and out of state.  I was floored when he told us that he had performed seven bypass grafts, not five.  I didn’t know it was possible for that many to be done…I’m not even sure what you would call it.  Septuple bypass surgery?  At that point I had heard of quadruple bypass and assumed that that was the worst.  How little I knew.

Dr. Geiss also told us that soon after anesthesia was administered my dad coded (both his heart rate and systolic blood pressure suddenly dropped to 30) and that he had massaged the heart back to a normal rhythm.  Afterward, everything seemed to go smoothly, although they did have difficulty weaning him from the heart-lung machine, which is what keeps blood moving through the body while the surgeon is operating on the stopped heart.  I remember him saying that if my dad was going to survive he absolutely had to stop smoking, and completely change his lifestyle.  Though he was in critical condition, the health care staff was “cautiously optimistic” about his prognosis.

That night I went in to see him.  It was one of the most horrible sights I had ever seen.  My father, who I had once perceived as invincible, lay there on a ventilator, heavily sedated, unresponsive.  Tubes and wires were poking out of him in every place imaginable.  The saddest change I noticed, and would continue to see in the coming days, were his hands…they were swollen at first, but as the swelling receded, his hands became those of an old man.  Not the strong hands that I had held so many times before…this really felt like the hands of some stranger.

The following days his condition did improve.  He went off the ventilator and was then able to speak.  He sat up about a day and a half post-op, and gradually started to move around, little by little, with a walker.  One by one the tubes were removed and IVs were taken out.  Finally, eight days after his admission, he was moved from CVICU to the cardiac step-down unit.

The night before he was discharged, I got sick with a sinus infection and was running a fever, so I told him I wouldn’t be able to come see him that night.  Much to my chagrin at that time, he kept insisting, so I agreed to come up there for an hour or so, to keep him company.  I warned him that I was not feeling well, but he didn’t seem to care about that…he was insistent.  That was eight days after his surgery.  We sat and talked for a while, and finally I was looking so tired that he did tell me to go home.

He was able to stand on his own again, so he stood up and I went over and hugged him, being extremely careful of his sutures and his one remaining IV.  

“It feels so good to be able to hug you again,” I said to him.  He nodded his agreement and I gathered my things and went to leave.  He waved, in the way he always waved to me.  We had a thing where we always waved to each other using the “Live long and prosper” hand gesture.  I didn’t do that with anyone else, just him.  It was our thing.  

So I returned it, and stepped out of the room.  As I turned back to look, there he still stood, still with his hand up, fingers split down the middle.  I smiled and waved again, then walked away, leaving him standing there still waving.

That is my last memory of him…of him waving goodbye.  It was like he knew.  None of us knew, of course, but it was like he did know, nonetheless. That is how I’ll always remember him, as I have come to reject what I saw two days later.  If I could erase from my mind how I saw him afterward, I would do it in a second.

It was Wednesday, February 8, 2006.  I was at work when my father’s girlfriend Pam (we all worked for the same company) came to my desk in a panic, telling me we had to go, we had to go now.  I didn’t think.  I just reacted.  I remember a co-worker telling me, “Go.  Just go.  Don’t worry about all that, just get your stuff and go.”  I passed a desk where my father’s boss was standing, with an expression of shock on his face that I will never forget.  I don’t know exactly when I realized that my father had died.  I don’t remember who said it, I just remember it sinking in.

Another co-worker that I didn't know drove Pam and me to my grandmother’s house, where he had stayed overnight because I was still not feeling well and because he couldn’t take the steps anyway.  I felt so sick.  What I had been trying to convince myself couldn’t happen had happened.  My dad, who was undoubtedly one of the people I was closest to, was gone.  In two weeks he had gone from “having the stomach flu” to this.

My father died at the age of 48.  My children, now 3 and 1, will never know him.

This is a story that I have been meaning to write for a few years now.  Now I feel certain that I’m doing it for the right reasons.  I’m not looking for sympathy; I’ve had four and a half years of that.  I’m doing this to help educate.  I wanted to share my experience because I do not take the statistics lightly.  I’ve seen them first hand.  As sad as this story may seem, it is not at all an uncommon one.  According to the American Heart Association: in 2006, the year that heart disease claimed my dad, over 425,000 people died from the very same thing.¹ 

Though there are uncontrollable risk factors such as age and family history, many of these deaths could have been prevented, including my father’s.  He was already high risk, being that he had a strong genetic predisposition to heart disease, but he also smoked close to a pack of cigarettes a day, ate most of his meals from restaurants and fast food, led a sedentary lifestyle, did not exercise, and did not see any doctor in the 10 years prior to his hospitalization.

So please…if you love your children, your grandchildren, and for heaven’s sake, yourself, please don’t take your life for granted.  I still very much grieve that loss, and for years I have tried to figure out why I couldn’t let it go.  Now I don’t believe I was meant to let it go.  I plan to go on to nursing school and become a cardiac nurse, and I want to focus primarily on education and prevention of this very thing.  Life is precious and it doesn’t have to end this way.

Thank you for listening.  

My father and grandfather, ca. 1960.

¹ http://www.americanheart.org/presenter.jhtml?identifier=4591

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In the years following his death, I have read his medical records front to back, again and again, looking for any detail that might give me some clue as to what the direct cause of his death was.  After working on a cardiac unit for nearly 2 1/2 years, most of the records make sense to me, where almost none of them did when I first obtained them.  This whole process has been a huge learning experience and I now have a better idea of what may have been going on at the time.  There's no definitive answer, of course, especially since I requested no autopsy at the time of death, but the different theories I came up with hopefully will help me in becoming a better nurse in the future.  At least, I hope so.