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My ‘Stroke’ of Good Luck

I'm still in the hospital recovering after a month but it could have been much worse.

by
Clayton E. Cramer

Bio

September 2, 2014 - 9:00 am
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Readers may recall my description of aortic valve replacement last year and a warning of the importance of treating heart disease seriously. Here’s another lesson from medical misadventure: if you are going to have a stroke, it is best to have it on an operating room table. And best of all, avoid strokes if at all possible.  As miserable and expensive as last year’s surgery and recovery was, I think I would make that trade.

This started as the classic symptoms of a heart attack on the evening of August 2: chest pain, pressure, left-arm pain, a sense of confusion. So I had my wife drive me to an urgent care facility, where they decided that I was beyond the level that they could treat other than giving me aspirin and nitroglycerin, and calling the Ada County Paramedics to transport me to St. Alphonsus hospital. In retrospect, my wife could have driven me there directly in less time, and saved the insurance company $1300.

All Comments   (20)
All Comments   (20)
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Get well, and REALLY well, soon, Mr. Cramer.

11 weeks ago
11 weeks ago Link To Comment
Clayton: May you have a fully and speedy recovery.
11 weeks ago
11 weeks ago Link To Comment
I have just one word of advice: don't let your wife (or husband) drive you to the emergency room. Call 911 immediately. When you come in by ambulance you are seen right away.
11 weeks ago
11 weeks ago Link To Comment
I'm not sure. I have walked in to the ER at Kaiser (where I'm a member) and told the triage nurse I wanted to rule out a heart attack. I was ushered into a bed immediately. (Turned out I wasn't having one. Don't know what it was.)

(I'm told they'd rather I come in and not need to than the other way around.)
11 weeks ago
11 weeks ago Link To Comment
Knowing the right key words may help, though.
11 weeks ago
11 weeks ago Link To Comment
Sorry, but no. And I'm a board-certified Emergency Physician, Director of Emergency Medicine at my hospital, and the Medical Director for my County. I used to be a professor of medicine at a rather large teaching hospital, as well.

Coming in by ambulance (AKA 9-1-1 Taxi Service) doesn't mean anything. Show up on your own with heart attack or stroke symptoms in MY ED (it's not called an ER and hasn't been for around 35 years) and you will be evaluated just the same as if you came in via EMS. A 50 year old with chest pains gets evaluated immediately, because time matters in coronary occlusion (and cerebral occlusion)

The advantage that calling 9-1-1 has is that if you are having a heart attack (especially) there are things beyond an aspirin that paramedics can do to keep you alive until you get into the cath lab.

If you are in a rural service area (and Clayton may be), you should find out what level of EMS is available - full paramedic service, EMT-Intermediates, EMT's. For heart attack and stroke a ride in the car (to the ED) may be better than calling EMS if paramedics aren't available. Paramedic level provider agencies have many more cardiac specific drugs, diagnostic modalities and airway interventions available than EMS agencies that have intermediates or basics, and sometimes that matters quite a lot.

It might also be a good idea if you're at risk for coronary or cerebral events to know WHICH hospital in your local area is the one to go to, too. A small rural or suburban hospital may not be a good choice if a large trauma center is only a few more minutes away - OTOH if you're bleeding, the rural hospital will probably save your life long enough to transfer you to the big hospital. You can always ask your own physician - but ask him which hospital he/she would want to be taken to in that situation.


11 weeks ago
11 weeks ago Link To Comment
Indeed, I live in a very rural area. As it happened, the severity of the situation didn't seem so bad when we left the house.
11 weeks ago
11 weeks ago Link To Comment
Understand. Heart attacks and strokes however, should be treated as an emergency until proven not.

And we are all glad you are doing so well. I believe G-D still has plans for you among us. And personally, I wish more of my patients (any of my patients?) were as compliant with their treatment as you.
11 weeks ago
11 weeks ago Link To Comment
Quite so.

Two years ago I had a pain in my back at the bottom of the left shoulder blade. My wife called 911 (Rural Metro here) and they were there in four minutes, had me hooked up to an EKG while I was in the Family Room, then asboard an am'bal'ance in 12 minutes.

I had the heart attack (actually, a blocked artery) on the gurney in the ER while the medical people were putzing around outside my stall. Thye managed to wake up and run me to the OR and put in a stent inside of a half hour.

They discharged me 30 hours later. Now my BP is typically 125/75 and the heart vessel has a tiny scar from for ordeal.

In sum: it was due to our PAID Fire Department getting me to the hospital in just minutes that made the difference.
11 weeks ago
11 weeks ago Link To Comment
Agreed. If you walk into the ER, you're a number, and if you're lucky, you MAY get seen in time. If you come in from an ambulance, you're Job #1.

I got lucky. I had a (fortunately, minor) stroke in 2003, and my wife, a nurse, drove me to the ER. Because she's a nurse, she knew what words to use and which toes to step on. All the damage was limited to the speech areas; since I was a full-time computer teacher, that was serious. It took me two months to learn to speak, and I still stammer when I'm tired.

Clayton, it sounds like yours was much worse. Get well soon!
11 weeks ago
11 weeks ago Link To Comment
Truly impressive luck with:time, place and expertise. Most assuredly was God's wish for your care and following recuperation. Is amazing how Our Lord works his marvelous miracles. We ALL Pray for your well being and return to full use of all your faculties. Pray. Amen.
11 weeks ago
11 weeks ago Link To Comment
Hang in there buddy.

Fwiw, my Dad was one of the very first recipients of an artificial mitral valve, early 70s. Thank God for modern medical science.
11 weeks ago
11 weeks ago Link To Comment
Or, thank medical researchers and schools of science and physics, not the schools of theology.
11 weeks ago
11 weeks ago Link To Comment
Hang in there.
11 weeks ago
11 weeks ago Link To Comment
Best wishes.
11 weeks ago
11 weeks ago Link To Comment
Hi Clayton,

Very glad to hear that you're recovering now.

I've still got "For the Defense of Themselves and the State", and reread it now and again. (talk.politics.guns seems such a long time ago, but arguments aired there ended up getting passed along to my kids, sisters, and various acquaintances, bringing them over from the dark side.)
11 weeks ago
11 weeks ago Link To Comment
Hi Clayton, we go back to the old usenet days on rec.guns. I recently read your book My Brother Ron, which was top notch research and writing - no surprise there. Sorry to hear of Ron's passing, and your recent troubles. I'm taking your suggestions seriously. Prayers for you and family. - Les Johnson
11 weeks ago
11 weeks ago Link To Comment
Get well, partner.
11 weeks ago
11 weeks ago Link To Comment
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