Well, that was fun (NOT!)

In October 2009, I suffered a heart attack, that led to quadruple bypass surgery.  Since then, I’ve had other medical issues, but my heart has behaved itself.

On Tuesday morning (November 5th, which is, perhaps appropriately in this case, Guy Fawkes Day), I had brunch about 10 a.m., carried on with my morning’s work, and took a brief nap during the early afternoon.  When I woke up, I had a tight feeling in my chest, not unlike indigestion, but it grew in intensity, centered over my heart, and I began to get radiated pain in my left arm.  Sounds familiar, no?

I called Old NFO, who kindly ran me in to the emergency room at Big Hospital in a nearby city (which was faster than calling an ambulance to come out from there, pick me up, and go all the way back).  EKG and other test results were normal, but since my first heart attack, they’ve developed some new ones, including a cardiac enzyme test.  The first reading they took was normal, but they had me wait in the ER to do a follow-up test, two hours later.  The second reading was elevated, indicating something was going on.  By then, my chest pain had subsided, but they kept me overnight for observation and continued testing.

By Wednesday morning, the enzyme level was very elevated, indicating damage somewhere in there.  An echocardiogram still didn’t show anything, so my cardiologist, who’s been keeping an annual eye on me since we moved here, scheduled a heart catheterization for Wednesday afternoon.  He found that one of the bypasses installed in 2009 had become blocked, in what’s called a “silent heart attack“, not presenting most of the usual symptoms.  Rather than open up my chest to repair it, he was able to unblock the artery that it had originally bypassed, using a balloon catheter and a stent.  (Apparently that technology has improved since I had bypass surgery.)

It was probably the weirdest surgical experience I’ve ever had (and I’ve had 19 surgeries so far!).  I was conscious throughout the proceedings.  To feel… things… crawling around inside me, snaking through my armpit to reach across my chest to the heart, was… it was unnerving, to put it mildly!  At one point, the surgeon casually remarked, “This is going to feel like fire ants crawling up inside your arm”.  It did!  Very uncomfortable, and really, really weird.

To cut a long story short, the procedure was a success.  I’m on added medication for the next year, to keep my blood thinned and prevent a clot forming in the stent (apparently the heart doesn’t like foreign bodies being shoved into it – who’d o’ thunk?).  I was released yesterday morning, with a warning to be very, very careful over the next week while my arm heals up – weight limits on lifting, no sudden effort, and all that sort of thing.  (Apparently major blood vessels don’t like having foreign objects shoved through them to reach the heart, and take time to get back to normal.)  I’ve also been warned (and have since experienced) that I’m likely to experience sudden shortness of breath and dizziness from time to time, but I’m told this will wear off after “some days”.

Thanks for your patience during my silence on this blog.  I probably won’t get up to full blogging speed until Monday, but I’ll try to put up something here and there to let you know I’m still around.  Thanks, too, for your prayers and good wishes.

One good thing about hospital stays;  if you can’t sleep, and have a laptop computer with you (thanks to Miss D. bringing it from home), you can still get some writing done.  I managed to write a chapter and a half on the work in progress, and I’ll pick up the pace once I’m over this.

Oh – one more thing.  If you’ve had any unexplained feelings in your chest that resembled indigestion, or shortness of breath, or anything else that worries you, you might want to read more about silent heart attacks.  I’m told they happen rather more often than people suspect, and can lead to future complications.  It can’t do any harm to check, if your medical insurance covers such examinations;  and it might help to prevent an early shuffling off of this mortal coil in future.



  1. Peter,
    I had a similar situation in January when one of my 4 bypasses blocked up and they put a stent in the original artery. Now that you are on the blood thinner be very careful. About 6 months ago I got a TINY cut in my groin area, about the size of a freckle. It took 3 hours in the ER to get it to stop bleeding.
    You are also lucky it took so long for your bypass to get blocked. Mine blocked up 33 months after the bypass.

  2. I'm thankful you are still with us.

    I wonder if your situation and location alters your tone of writing.

    Take care.

  3. We'll be here, praying for you and Miss D. Get well and focus there. Your books are well worth a second or third read to get a better feel for detail, so the clamor is muted for a while.

  4. Glad to hear you're in care and improving. While not on the same level, I had the peculiar experience of watching the replacement of my eye lenses "from the inside".

  5. Hey Peter;

    I am really glad that you went and got checked out and that everything is ok. And thanks for the warning on the heart issues. Stuff to pay attention to.

  6. Thank God you have pulled through it! And I second the caution about minor cuts. Time to he very careful. The world needs many more of your great books.

  7. Hi Peter,

    Glad to hear you're out of immediate danger, and that they didn't have to crack open your chest!

    Take whatever time you need, we'll be here when you get back up and running.

  8. At tip, RE: blood thinners (Plavix, Warfarin, and the newer ones, etc.).

    I'd suggest a Medic Alert device – bracelets are more obvious than those worn around the neck – stipulating "ANTICOAGULANT-SEE WALLET CARD" and a prominently-visible laminated wallet card with the name and dosage of whatever blood thinner you're on. A laminated bright da-glo orange card is not overkill.

    First, if you're cut, you'll bleed. Profusely, even from small cuts. Second, I'd add a few clotting sponges to your home first aid kit AND the IFAK you carry with you (you do carry one, right?); the sponges will tide you over while traveling to an urgent care facility if you experience more than a very minor cut because you'll probably need expert assistance in controlling the bleeding. Third, be aware of bruising, because a bruise which is "nothing at all" without thinners is potentially serious with them; a seat belt bruise from a traffic accident requires expert attention, deeper bruises can be quite serious because the internal bleeding will not be immediately obvious.

  9. Ditto being extra careful while on the blood thinner.
    I've been tied up the past week and more with a family medical situation: my father was on Xarelto for an earlier problem, and developed (as it turned out) a blood leak inside the skull… either as a result of a minor fall that didn't involve hitting his head on anything, or before that and it caused the fall; we're not sure.
    Took a CT scan to diagnose it; the usual stroke screening tests seemed to show he was OK, but it had been gradually becoming apparent to me that he was not at all OK. The leaked blood having been drained, he's now on the mend.
    Additional note: sometimes, it really helps to have someone force-feed clues to the ER staff until they come up with a diagnosis.

  10. Blood thinners can be insideous. I'm on dialysis, so recieved a dose of heparin twice a week to keep the dialysis machine from clotting up twice a week. An intestinal bleed from a diverticulum two days after a dose resulted in a six day hospital stay and four units (half my total blood volume) of blood. So do take any bleding very seriously!

  11. Glad to hear you're back on the mend. Things like this can come up unexpectedly. I have a friend, not over-weight and regular in his exercise, experience tightness in his chest. A couple days later he had quadruple bypass surgery. Luckily he's doing well now. Heal quickly.

  12. VERY glad to hear they identified & remedied the issue(s). Please take care of yourself, sir, and know we're praying for you.

  13. Glad you're ok. I've been out of work for several months following triple bypass surgery after my own silent attack, so I can sympathize. Decided to focus on improving my situation. I've lost 40 lbs so far, and starting a new job next week. Take care and good luck.

  14. You seem to have good medical care and a surgical team that knows their business. I'm glad that it ended well. Every day above ground is a gift.

  15. Rest…. ore rest and stop attending gentleman's clubs and partaking of liquor 🙂

    Kidding aside, Take care. Our models are obsolete and no parts are being bade

  16. You wrote a chapter and a half while going through all this? Sheesh, Peter, you're making the rest of us look bad!

  17. Glad to hear you're recovering well. Three years ago, while moving out of my house, I had some odd things happening, so went to see my doc. Sent me to a cardiologist, who said "First we must have a stress test, and got started, and then said "NOPE! You'd fail." Set me up for a 4-leaf-cloverleaf 4-way bypass. Surgery Tuesday, released Saturday afternoon with a bottle of oxycodone. Sunday I woke up pain-free I've been fine ever since.

  18. Glad to hear you have not passed into the good night. Looking forward to the next release as I have enjoyed all the stories you have shared.

  19. Wow! Sorry to hear about that whole fire ants up the arm thing. Most definitely sounds unpleasant, and I don't know I would be able to handle it. Focus on the good news: they found and fixed a problem, so now we can torture you for awhile longer than if they hadn't. Sound good?

  20. Beware of effects of wi-fi close to your body. When using a tablet or phone (worse)
    if it is turned on or in use near your heart it is of concern. Suggest you do some
    research. I wound up in hospital from resting a laptop on my chest while watching

  21. Glad you weathered the storm.🙏

    If there's any chest or arm discomfort, 'tain't "silent".

    Anyone who's worked in that area has a stash of stories on the subject. Could make quite a book, but the laity would miss the points, while it would bore those in the know.

  22. @Robin Datta: It had probably become blocked some time before without my noticing, hence the "silent heart attack" label.

  23. Glad that all worked out thanks to the the advances of modern surgery. Must have been a bit of a shock, so take care and give yourself the time you need to fully recover.

  24. My goodness, I'm glad to hear that you're going to be alright! "Silent Heart Attacks"… what a scary grouping of words *that* is. I thank God that the doctors figured it out, and were able to remedy it.

  25. Happy to hear the medics got it sorted out for you, Peter. You are one of my go-to reads daily, want you hale and hearty for as long as possible! Selfish of me, I know…. Now maybe you can use your invalid status(!) To get that other African ex-pat (Law Dog) to scribble a tad, y'know, to take up some slack…. 😎 Kidding, but do get well , Padre, we can't spare the good men we have….

  26. Even those who think they're healthy should learn the symptoms of a heart attack. If I hadn't known them I wouldn't be here today – I had the mild initial symptoms almost exactly a year ago, and called for immediate help. I died twice on the operating table.

  27. Peter, I'm glad that you're going to be okay. You and OldNFO (along with LawDog getting his stuff put together into book form) have inspired me to get off my duff and get going on the writing thing. I've been busting with ideas for so long, it's time I'd gotten around to putting some into motion.

    My mom (now in her early 70's) had this same procedure at the beginning of last month. She described the feeling the same way you did. She's glad she had it done, but definitely did not enjoy the experience. I'm guessing that the two of you are on the same blood-thinner. With her, it complicates things because her cardiologist refuses to get cortisone shots in joints. Doesn't want to risk the bleeding with even the small (multiple, but small) cuts the needles make.

  28. With oral anticoagulants that are Vitamin K antagonists, they act in the liver, where Vitamin K is needed as a co-factor in the synthesis of blood proteins that are part of the clotting mechanism. By blocking the places where Vit K acts, they prevent the synthesis of those proteins, and blood levels of those proteins ("clotting factors") are depleted to an appropriate level in 72 hours.

    Vitamin K is sourced by the body from (esp. green, leafy) vegetables and colon bacteria. Antibiotics, particularly those which affect the colon bacteria, such as the "floxacin"s, will further reduce the Vit K and increase the anticoagulant effect. I have had patients on Vit K antagonists die of brain bleeds when given antibiotics for unrelated reasons.

    Some primary care providers and pharmacists may overlook this: patients should be aware.

  29. 1) Best Wishes for a speedy recovery.
    2) Troponin is the cardiac enzyme we track.
    An initial negative is great, but it can take half an hour to a couple of hours to rise, indicating damage to cardiac muscle. Imagine our annoyance (and yours) if we in the medical profession sent you home after the first test only, and it turned out the second or later would have indicated a serious problem. So we don't.
    3) CABG (coronary arterial bypass grafts) were state of the art – in 1990. But they hurt, require yanking veins from your leg, and long-term rehab. And they clot up in a decade or so.
    Stents (which look like the springs in a retractable pen) last longer, are simpler, and as you experienced, are done under local rather than general anesthesia, decreasing markedly the complications (oh, and the risk of dying). Once placed, they are released to uncoil and open up clogged arteries. Presto!
    And you get to go home in a day or two, rather than two weeks or more.
    And can be re-stented down the road, if needs be.
    Better in 37 ways.
    4) Anti-coagulants do what they do.
    You have other risks: ANY sort of fall or head injury means you're getting a head CT, because you're at a much greater risk for hemorrhagic strokes and brain bleeds in the event of any trauma.
    You get hurt, the first med you report to them is your anti-coagulant: name, dosage, frequency.
    5) If you're on more than two meds, you should have a card in your wallet right behind your ID, with all the names, dosages, and frequency of all your medicines. And any allergies. And your list of medical diagnoses. And surgeries. And your doctors' names and phone numbers. And you should have the same thing for your wife, and vice versa. You may be answering questions for her when she cannot. She may be for you. Tis is belt-and-suspenders stuff. If anything happens, playing Twenty Questions with one's spouse/significant other in the ER sucks. They'll always pull your ID, and thus find your Medical History card.
    Make two, without fail. Today.
    Give one to the Mrs.
    Then do hers, same-same.
    6) If you have chest pain that goes away in twenty minutes or less, and it was provoked by strenuous activity, nobody cares.
    But when it's unprovoked, doesn't get better with any meds for the occasion, you think it's serious, or it lasts longer than twenty minutes, your very next step is going to the ER. Period.

  30. (cont.)
    7) Your ride to the ER is nice. Beats heck out of driving yourself and maybe dropping dead in the fast lane, and taking out a schoolbus on the way. And no shade on him, OldNFO is a stand-up guy for taking you.
    He picks you up and you drop en route, WTH is he (or your wife/friend/neighbor/etc. )going to do about that??
    CPR with one hand, and steer with the other?
    Pull over and call 911, and hope they find him?
    I hope you're catching my drift, Peter:
    When a paramedic ambulance pulls up, they bring an advanced EKG machine, a cardiac defibrillator, oxygen, IV access, a tackle box of cardiac drugs to you, and you travel in a mini-ER from your door to the ER, in full contact with a high-level hospital the entire time.
    If anything happens, you'll be getting first world medical care that instant. Not 10, or 20, or 40 minutes later.
    To drive the point home: if you have a heart attack, and no one with a defibrillator and cardiac drugs gets to you for 15 minutes, they may as well call a hearse. You died, and all you are from there on out is an organ donor. Maybe.
    Your chances with a heart attack in a paramedic ambulance are within a percentage point or two of the same problem in the hospital, for survival. But you lose 5-7% of your survival odds with every minute of delay between cardiac arrest and the arrival of medical interventions. So at about 15 minutes time down before the arrival of cardiac drugs, monitoring, and if indicated, electro-cardiac shock, your survival chances are at about 0%.
    Thus endeth the sermon. (I yell because I care.)

    And I'm really glad everything has turned out okay so far.

    Follow Doctor's orders (like you will), and do a little research and self-education, so you know almost as much about what's happened and what might as your doctor, and you'll have a much better life in the interim between now and when it's over, someday.

    Everyone loves Jesus, but nobody's in a hurry to him, right?
    When the time comes, it comes. But let's not rush it, shall we?

    Again, sincere best wishes.

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