In my years as a prosecutor, I saw plenty of violence, including many deaths. Some were accidental, but some were the work of killers, even serial killers. I have always been fascinated by serial killers. How do they choose their victims? How is it that they can take a life so easily? I studied them, tried to understand their behaviour. None of that prepared me for the day I met a serial killer of a different sort - a medical one with the ominous name "the widowmaker" - that had come for me.
On Tuesday, January 13, 2015, I suddenly became wide awake at 5am. I lay in bed with my eyes open for maybe a minute, thinking, "Hmm, this is weird," and then, "I feel kind of funny". Within about 30 seconds I rushed to the bathroom and threw up. I felt very cold and climbed back into bed with my husband and snuggled back under the covers. A minute later, though, I knew I was going to be sick again. I figured I was coming down with a virus, but it was strange how suddenly it had come on.
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Steering clear of 'the widowmaker'
The name sounds frightening, but this cardiac event is named for good reason. Here's a look at some of the early warning signs of 'the widowmaker' heart attack. Vision: Lee Memorial Health System
My husband, Tim, was concerned. He sat beside me, felt my cold, clammy forehead and said I just looked so pale. Then he whispered, "Let's go to the emergency room." I laughed. "Why?" I asked. He replied, "You could be having a heart attack."
Tim's father had died of a heart attack at age 64 after feeling the classic stabbing chest pain and heaviness in the chest that you always associate with a heart attack. But that wasn't me. I was 46, I just had a bit of a bug, probably a 24-hour thing. I just needed a little rest. Tim wouldn't have it, though.
And so 30 minutes later we walked into the emergency room at the Vanderbilt University Medical Centre, where half-jokingly I said, "My husband thinks I may be having a heart attack."
If you want to get past the first stage at the ER quickly, that is the way to do it. They walked me directly to the back and told me to have a seat. They brought over a portable EKG machine and hooked me up. When the results came back a few minutes later, the ER doctor said, "Hmm. Well, it appears to be a little abnormal, but it's hard to believe you're having a heart attack." "I know," I said, rolling my eyes and feeling embarrassed.
He asked me a bunch of questions. Nope, I don't have chest pain. Nope, I don't smoke. Nope, my cholesterol is normal. Nope, I don't have any history of heart problems in my family. I exercise regularly. I eat well. I have never had a surgery or even been seriously ill. Gee, I have never even had an IV. I'm super healthy. He commented that I look healthy, am not overweight, in good shape. He decided to do another EKG in 10 minutes or so.
A bit later, with the results of that second EKG in her hand, a nurse looked at me and said, "Things are going to start happening really fast. In a couple of minutes there are going to be a lot of people in this room, moving very fast. I don't want you to be scared." I said, "Okay." I wasn't scared. I still felt fine and, as far as I knew, all was well. I didn't feel sick anymore, or even funny.
The next thing I know, I was on a gurney with tremendous activity around me. One person was pulling off my clothes, another was sticking a needle into my left arm, another into my right arm. There were at least four other nurses and doctors moving around fast, doing I don't know what. At that point, I started to cry. Suddenly I was scared.
From my right came a gentle voice. I looked over to a man in a white coat, who took my hand. "My name is Dr Fredi. I am the boss of all these people. We are going to take you upstairs and see what is going on with your heart," he said. "If there is something wrong, I am going to fix it. I'll treat you just like a member of my own family." I said, "Okay," Tim gave me a kiss and, in a flash, I was off.
They took me to a big room where everything was white and there were bright lights, a lot of medical equipment and a bunch of people in scrubs. At least that's what I recall. I remember people telling me, "Dr Fredi is the best, and he will take good care of you." Then I was out.
When I awoke, I was in a different bed in a different room. Tim was there. He told me that I had had a major heart attack, that I was in the process of having it when we went to the hospital, and that Joseph Fredi, an interventional cardiologist, had been able to stop it in its tracks. He literally stopped the heart attack while it was happening by suctioning out a blood clot and putting two stents into my right coronary artery through a tiny hole he pierced in my right wrist.
Fredi had taken me into the catheterisation lab and determined that my right coronary artery was 100 per cent blocked, and the centre artery, called the LAD, was 70 per cent blocked. LAD blockage is the problem they call "the widowmaker," because it is the most frequent source of sudden death. It kills a lot of people, including Sopranos star James Gandolfini. (Comedian Rosie O'Donnell survived hers.) Doctors say it's a true serial killer.
Plaque had ruptured in the wall of my right coronary artery, which caused the clot to form and can produce the sort of nausea that made me throw up. That was my only warning sign. If I had gone back to sleep that morning, as I had wanted to, I may not have awakened, and if I did, there probably would have been devastating damage to my heart. As it was, I had no damage.
When I sat down to write this story, I wondered where it should end. I guess the most important thing I can tell you is how it didn't end. Heart disease is the No. 1 killer of women in the United States - with nearly 300,000 deaths a year - but I survived this serial killer. I just passed the one-year anniversary of my heart attack. I took a nuclear stress test the other day. My heart, Fredi says, looks perfectly healthy. There is no sign of scar tissue, and I'm able to lead an active life doing anything I want.
My good health is due to one thing: early intervention. Because my husband got me to the hospital so fast, Fredi was able to save me and save my heart. So my lesson is this: Don't think it can't happen to you. Just because you're young and healthy, because you don't smoke or drink, because you work out and you're thin and you eat well and you've never had any medical problems and you have no family history, don't think that you can't have a heart attack. You can.
They are still not sure what caused mine.
I would tell you to trust your instincts - except in this case my instinct was to chalk up my symptoms to something else and to worry about whether the doctors and nurses would think I was crazy. So I'll say don't trust your instincts, if your instincts are to wait and see what happens. When you just don't feel right, don't ignore it. Fredi says that 9 out of 10 women with my symptoms would not have gone to the hospital. I wouldn't have gone either, if it weren't for Tim.
Many women have no chest pain, no tightness, no pain in the arm or jaw until it is much too late. Many women suffering a heart attack simply "don't feel right," just as I did. So if that happens, don't ignore the feeling and don't worry about someone thinking you're crazy. Get yourself checked out. The worst thing that happens is they send you home and tell you you're fine. You can live with that.
Sue Palmer is a lawyer in Nashville.