Surviving a widowmaker

Estelle and I knew being overseas for seven months in Egypt, South Africa, Australia, etc had risks. And we knew at our ages that unforeseen health issues can happen, but we’ve both been very healthy and I don’t think we gave that risk a lot of consideration.

So, we land in Johannesburg Monday night after two weeks in Australia, back with family, Wednesday morning I feel some mild chest pain. It comes and goes, feels like some kind of indigestion to me. The next day, Thursday, it’s still there, doesn’t respond to normal indigestion medicine, and it feels somehow different than previous indigestion pain, and I did just turn 72. So I call our long time friend, Etienne, an MD in Pretoria, about 5pm on Thursday to get his opinion. After a few questions he says I should come immediately to the hospital he thinks is best, in Pretoria, with the best cardiologists, who he knows personally, just in case…

Still believing this is just indigestion, Estelle and I drive about an hour to the hospital, get in about 6PM. Etienne walks us into the emergency room, and they have blood work results and EKG in about 30 min. Then, the emergency room doctor says, “You are having a heart attack and need an arteriogram ASAP.”

My first reaction is disbelief. There’s a mistake. I call in Etienne, call David, my 50 yr friend and personal doctor in Nashville. Help! Etienne calls his cardiologist friends. The verdict is unanimous, get on with it.

The problem is the hospital has no beds available. And Etienne's second choice is also full, apparently a frequent problem with the top private hospitals here. And they really don’t think I should be transported anyway. Etienne gets on the phone, and after a number of calls, the cardiologist makes a bed available and agrees to come in that night, with his team, to do the procedure. Everyone understands, time is of the essence.

Estelle’s brother Ben comes over from his home nearby to be with Estelle, who, like me is struggling with the possible outcomes we could be looking at. So glad she is in the bosom of her family here in South Africa. It is certainly a comfort as we face the possibility of her suddenly being on her own.

They fairly quickly have me prepped and in an operating room with about 6-8 folks ready and begin the procedure about 10 pm, with me awake, under a local anesthetic. Sort of like the scene from Caddyshack where Bill Murray talks about his caddying tip from the Dalai Lama: “'…when you die, on your deathbed, you will receive total consciousness.' So I've got that going for me … which is nice.”

After a while as I listen to their medical language, the doctor tells me that the LAD artery is 100% blocked and he’s going to try to clear it out. My thoughts are optimistic, seems like this is fairly routine, for them—but I do pick up on the word, “try.” Then he calls for “1 by 12, 1by16, 2by12”,…eventually ending at 3by36 which I understand to be sequential stent/balloon sizes. Finally he says, “we’re done. It’s clear and flowing.”

A couple of recovery days later, I’m still in hospital but doing well. I’ve had remarkable care here. The doctor says I should be good to work back up to normal activity. Still have the reality of heart disease but with some new medications and work on my diet that should be manageable. Finally able to sit up in bed, I've started doing some research. Here was the first thing that popped up.

"A widowmaker heart attack is a type of heart attack that's caused by a 100 percent blockage of the left anterior descending (LAD) artery. ... If it's blocked, the heart can stop very fast."

Estelle and I talk about how lucky and grateful we are, and facing the most serious look at our mortality ever, we’re really glad we still have each other. And given the many times and places in our travels, like Egypt on this extended trip, where this same event could have ended much differently. We’re talking about how we change our eating habits. I know better nutrition and lower weight will be my best defense for this now-known, chronic condition.

Discharge a few days later and then back to Dr for a few post-event checks, including EKG, Coronary ultrasound, and CT Coronary. Dr seems pleased with how it’s all performing right now and expects a normal recovery—with adherence to medications and physical activity guidelines. He’s cleared me to drive and to carry on with our plans to rent a house adjacent to the Kruger National Park next week.

A word to the wise. Get good travel medical insurance. With our multiple trips and long time away from home this year, it was hard for us to find, but it’s readily available for normal trips. Medicare doesn’t pay anything in another country so we are on our own nickel here. Luckily the cost of good healthcare in South Africa is much less than America, or Europe, or Australia.

In my surviving evangelist role, my message is: don't play with chest pain. I had none of the other symptoms associated with heart attack. Even with all the climbing in the Drakensberg, active travel in Australia, and continuing exercise, over the last month or two, I never was short of breath or felt any other warnings. If you have chest pain, get thee to an emergency room quickly.