Ouch! I Cut My Thumb, Part II, The whole story, Heart Attack and All

I am not sure how to do this.  Two days ago during a beautiful stormy winter day here in Maine I kept busy through the day doing my normal chores as prescribed by my lovely wife Lela.  I was nearing the end of my day, winding down, and I started out to prepare dinner.  The first thing I attempted was to cut up some potatoes and before I was half way through the first spud I sliced into my thumb.  I wasn’t having a heart attack, just bleeding.

No big deal, but since I take a blood thinner I couldn’t get it to stop bleeding.  I suddenly found myself one-handed and in no mood to cook supper so I sat down and started this post.  As happens with many of my posts once I began writing the story developed a life of its own and before I concluded it I ran out of steam, for two nights running now, and it’s getting late tonight.

I’m going to blame my inability to climax the story on my blood loss, which is embarrassing.  Now that I’ve replenished my supplies of iron and am once again clear-headed I am ready to go all the way.

Thanks to a comment from my friend Mike, whom I haven’t seen for way too long a time, I realized that I had published my uncompleted story.  While I was writing it I thought I was saving my draft and would be able to complete it today without anyone knowing the difference, unfortunately at some point I hit publish instead of save.  I type bad enough with two hands so I’m not surprised that happened while I was typing with one, especially with the short arms I have.  Mike will understand what I mean.

So here for your approval, or disapproval, whichever it might be, is the story from beginning to end with two nice pictures of the beautiful winter scene I took from my front window during yesterday’s storm.  These pictures are in full color.  It was a very white, snowy winter day.  These peaceful beautiful scenes are one of the few benefits of living where there is four seasons.

Finally a little PS, for lack of knowing a better description.  For those of you who read the first post and are coming back to see how the story ends.  Picking up from where you left off is fine, but I have made several changes throughout the post in hopes of improving it.  Any of you that brave reading both let me know if my adjustments were an improvement or a waste of time.

2013-02-24 13.16.132013-02-24 13.16.20The Story:

I wasn’t even thinking of posting today, but sometimes plans change.  It seems I have some free time on my hands due to a simple kitchen mishap with my favorite chefs knife.  While cutting up some potatoes for a bit of delicious oven baked home fries I slipped and sliced into my thumb.

No big deal, a small cut.  Unfortunately I take rat poison as prescribed by my doctor.  Rat poison you think?  How preposterous?  Not so fast my medically disinclined friends.  I, like several million others who deal with hearts that just can’t get their rhythm right, am prescribed warfarin sodium, the generic name of Coumadine.  It’s the same ingredient used in many rat poisons that work on the premise that if you get a rat to eat enough his blood will get so thin it will bleed to death.  Now you can feel bad for that particular rat, but rats have been at least partly responsible for many of the worlds worst pandemics.

So how did rat poison become an important weapon for modern cardiologists?  I really don’t know, but I bet it went something like this.  Once medical science advanced to the point where it could keep more patients alive who had heart attacks or heart surgery a new clotting problem developed.  Many of these patients developed arrhythmias from scars created when heart muscle died during their attack, or from scars in the heart muscle they got during surgery.  Most of these arrhythmias are rhythms that go too fast.  When your heart beats too fast it doesn’t perfuse the blood out of the heart like it should, leaving it to pool in the chambers, usually the atriums.  Which, I think, is a fancy way of saying when your heart beats too fast it can’t keep the blood flowing out to the body and lungs the way it should.

When blood isn’t flowing it is congealing and that’s one of the way blood clots form inside the body.  Small aside;  blood clots formed outside the body are usually refered to by their more common name, scabs.  A blood clot, like a scab, can peel off where it forms then move around the body until it gets to a vessel it can’t fit through.  If the blood vessel the clot gets stuck in is a vessel that feeds the heart or brain and the blockage makes it so blood can’t flow through that vessel to provide oxygen to the cells on the other side, those cells start to die.  That, right there, is the anatomy of a heart attack or stroke.  Either one may be mild, but they also may be debilitating, and in some cases deady.

When this happens medical people refer to time being muscle or brain cells.  A reference to the brain or heart muscle cells that continue to die as long as the blockage remains.  That’s why if you or someone you know develops symptoms of a heart attack or stroke it is incredibly important that you react, without panicking, quickly and intelligently.  These are the signs of a heart attack and stroke from WebMD This is what you should do if you think you are having a heart attack or stroke.

Just as in my life, when I work to fix a problem, there is a large chance that I will create a new larger problem that I had never thought about.  When heart surgery started saving people and doctors and emergency responders started saving heart attack and stroke victims they must have been surprised and totally bummed out when those patients they worked so hard to save later started dying from blood clots.

At some point I am going to look up and tell you the real story about how doctors started prescribing rat poison to heart patients to keep them from clotting and developing new and maybe even worse afflictions, but until then I am going to go with this story that I am making up.  To repeat, this part of my post is fake, made up, not true.  Do not try to enthrall friends by sharing this story as fact unless they just were doing bong hits of Sinsemilla.

In the early 1930′s in New York there was an owner of a huge pest control company.  The company was a nationwide company.  It traded on the New York Stock exchange.  The owner, George, was a hard-working man with a quick brain and an inquisitive mind.  George was a driven man and worked sixty plus hours a week.  He not only had a company listed on the stock exchange, he also owned lots of stock in a variety of other companies.

At some point in the mid  thirties George developed hypertension.  His doctor said his blood pressure was going up quicker than his stock portfolio and told George to ease off the throttle, find a way to relax, and above all stop smoking.  George, being the good American he was, did none of those things and kept going.

Heart Attack

It wasn’t long before it happened.  George had a heart attack.  He was fortunate to be near a hospital when it happened and the doctors quickly and efficiently fixed him up and sent him on his way.  He received another stern speech about making good life choices from his doctor.  George, scared by his heart attack, paid attention to taking better care of himself.  He stopped smoking, watched what he was eating, and attempted to exercise regularly.

George was okay for a bit, but within a year he slipped back into his old ways, unable to resist the fatal attraction of his past bad habits.  Soon he had another heart attack and this time his heart attack affected him beyond just the initial attack.  Now he was constantly short of breath, he couldn’t exert himself at all, and he always ran out of strength before his day was half through.  This time he wasn’t just scared, this time he wanted to know what was going on, how it would affect him in the long run, and what he could do to keep from having anymore events.  George’s mortality was pounding on his door and it frightened him.  George started asking his doctor questions.  What was happening, why was it happening again, and how worried should he be?

One cardiologist patiently sat him down and slowly explained how the heart works.  He diagramed out how the blood flows through the heart’s chambers and then back out to the body and lungs.  He made clear how blockages happen, and highlighted that some of George’s heart muscle had died and how that increased George’s chances of having more attacks.  This was because of the blood pooling in his chambers when his heart beat too fast because of the arrhythmias caused by the scar tissue in his dead heart cells.  He further explained how when blood pools it can coagulate which can create a ticking time bomb that might lead to his next heart attack or a stroke.

George went home that night and thought about all the information that he had seen that day and about the other material he’d been studying at the library.  His internet connection was going to be down for many decades to come so he broke out the books he borrowed from the library and a pencil and pad of paper.  He studied the heart anatomy, it’s pumping and plumbing, and its electrical system.  He was encouraged that the doctors had helped him survive two heart attacks and he was discouraged that the more heart muscle he lost the more likely he was to have another heart attack or stroke.

As with many people who have to deal with a serious medical issue George had to admit his fear.  This particular night while in his home George went to his private office where he lit a small fire in a field stone fireplace.  This was the room George retreated to when he was trying to deal with serious issues.  The rest of the family knew not to disturb him while he was in his office unless absolutely necessary.  And if he lit a fire no one should interrupt him unless the fire spreads to other rooms.

As a succesful business owner George knew how to solve complex problems and he was certain he could find a solution to his medical problems the same way he solved so many other challenging problems.  First he organized.  Books and articles dealing with the plumbing of the heart were on the left side of his oversized desk.  On the right side was a pile of information about the hearts electrical system, and in  the middle George had information about the anatomy of blood, how it flows, how it carries oxygen and nutrients, what causes it to coagulate, and even more relevent information that I am too lazy to include here.

He had an easel with an oversized pad of paper that he used for notes and outlined the difficult problem he was trying to solve.  George’s office had taken on the look of an office of a graduate student working on a thesis.  Underneath this mound of medical information was the normal paperwork, trade magazines, etc. from his national pest control company, a business he started from scratch.  As pressing as his medical issues were he still needed to keep his pest control empire rolling.

George was an aggressive, hard-working, very succesful business person who liked to tackle problems head on.  And his mentality was that if he didn’t know enough to master a problem he turned to hard work, study, and patience to overcome the barriers in his way.  There had been very few obstacles he hadn’t overcome.  He was sure this unwavering perseverance would get him the answers he was looking for on how to keep blood from coagulating in heart chambers when the heart beat to fast and the blood began to pool in the chambers.

He worked late into the night and though he had taught himself a great deal about the deadly problem of clotting.  He still had no idea on how to solve it.  He stayed at it so late that he actually fell asleep at his desk.  He awoke early the next morning and as he came to he knocked several books and papers onto the floor.

He slowly picked up the papers, dejectedly placing them back on the desk.  And then it happened.  When he was done picking up the papers he looked down on them preparing to reorganize them.  And he saw laying there next to each other a diagram of the heart and its chambers and another paper advertising rat poison.

And he had a vision that would change the lives of millions of cardiac patients.  His idea was using the rat poison that he had made millions of dollars with by killing rats to hopefully thin people’s blood just enough that the pooling blood wouldn’t make clots, but not so thin that they’d be in constant danger of bleeding to death.

He brought his idea to his doctor who said, “That’s interesting.”  He talked to his rat poison supplier who said, “You want to do what?”  He went to the local university that had a medical school where they thought he was crazy.  Day after day he spent countless hours pounding on doors and writing letters all to no avail.

Then one day a business associate set up a meeting for George with the chairperson of a large pharmaceutical company and George was sure his efforts were about to be rewarded.  They met and the chairperson carefully listened to George’s whole presentation without once interrupting him.  The chairperson was impressed with the presentation George made and how informed he was.  It was obvious George had worked hard and mastered the material he was covering.

When George finished his presentation the chairperson asked him some serious questions about what dose George thought would work, what kind of supply there was for warfarin sodium, and what kind of price structure George thought would work.  At the end the chairperson thanked George for what he said was one of the best presentations he’d ever seen.  He told George that he would take the information to the board and see if he could get them to commit to setting up a team to investigate the possibility of putting a team together to take the initial steps to create a new medicine.

He told George to go home and relax for a while and he would get back to him.  He told George that the process was long and arduous, but that from George’s presentation he thought they had the makings of a winner.  Over the next half-year the chairperson kept George patient by phoning him regularly and giving updates of the progress he was and sometimes wasn’t making with getting the board to sign off on moving forward.

George was excited.  He knew that a medicine of the scope they were talking about would make a lot of people, including himself, very rich.  George was already very rich so his real driving force was saving lives, including his own.  He began to fantasize about his legacy being the man who saved arrhythmia patients from heart attacks, strokes, and dying.  That was a legacy he was going to be proud of.

A year had gone by when the chairmen asked George to come see him.  The chairperson explained that because funding was so tight a majority of board members were holding the process of moving forward up.  He suggested George might want to go out and raise some seed money to help tip the scales in their direction.

George was happy to go do it.  He liked the fact that he finally had a problem he could help with.  He always felt better about a project succeeding when his hard work might be the reason that ensures success.  If all they needed was some hard work raising money then he knew he was more than capable of doing it.

George was out on the street every day visiting equity investors, bankers, insurance companies, and any other financial entity that might lend seed money.  Everywhere George went they applauded him for what he was trying to do, but no one felt comfortable investing in rat poison as medicine for humans.  By this time another year had gone by and George was distressed about the whole project.  His own business had suffered due to his lack of attention and he found himself selling off whole territories of his once thriving pest control company.

One day while reading the Harvard Medical Review he saw an article about a new drug therapy to help prevent blood clotting for patients that suffer from atrial fibrillation.  When he opened to the article he was stunned to see that the chairperson of the pharmaceutical company he was supposedly working with had an interview in the article describing how they developed this drug.

George was heartbroken, he was sure he’d been screwed.  The article stated that they were in stage two of their trials, everything was moving ahead smoothly, and the results were promising.  Obviously the chairperson had been deceptive.  George called the chairperson and asked what was going on and the chairperson gave him an ultra song and dance that left George’s head spinning.  Claiming what they were doing was completely different from what George had proposed.  George asked if that were the case then why were they using the exact same chemical in their drug as George had proposed to use in his?

After getting no answers from the chairperson George slammed down the phone.  Immediately he called his lawyer and spewed out the whole ugly ordeal.  He yelled and screamed.  He quietly whimpered.  Suddenly George grabbed his chest in agonizing pain.  Poor George Had a massive heart attack right there and then.  A clot had formed in one of his atriums, broke off, and caused a huge myocardial infarction.  He died almost instantly.

Within years a new medication, that was made from the poison used to make rats bleed out, was approved for use in humans.  The pharmaceutical company George had talked with patented the medicine and since has made billions of dollars from it.  George may never have had the deadly heart attack if after his first heart attack he was prescribed a coumadin regiment.  The company never acknowledged George’s involvement in the development of the medication and after George died the pharmaceutical company bought George’s pest control company in a move to diversify their company.  They paid George’s family pennies on the dollar for the then ailing company.

This great American folk tale is brought to you by Killme Pharmaceuticals, proud makers of Cowdungeprone.  The next generation drug for the prevention of your financial independence.

Remember your good health is the best medicine to being healthy.  If you don’t get sick you won’t be sick, we guarantee it.

4 comments

    • Hey Mike, I hope you weren’t disappointed with the ending, but I thought I would end it cold, short, and clinical just like how the conglomerates do it.
      So what’s up with your A-fib? How long have you been dealing with it and does it affect your daily life?
      My arrythmias started in 1996. The doctors said it was because of the scars in my heart from my surgeries from when I was a kid. The arrythmias caused a lot of my heart muscle to die leading to cardiomyopathy and that has led to heart failure which is becoming more congested as I get older.
      I have many fond memmories with you from days gone by. From debating the virtues of arm length to hanging around a campfire at a keg party listening to you and Dave jam. We sure did know how to party, though it did finally dawn on me that my drunken harmonica playing was not attractive and I learned not to drink and play. Eventually I had to learn to just not drink and which was instrumental in limiting how much trouble I was always getting in, as well as keeping me alive as my heart has weakened.
      I remember playing vollyball in the backyard of the house you rented, playing the tamborine at your apartment over the new Barnies, and getting totally confused by some kind of Afghan you had in your closet one night at my parents house.
      I’m a grandpa now. I have two wonderful grandchildren that are the joy of my life. I can’t believe I’m a gramps, who’d a thunk it, but here I am. I love it. My only trepedation is being married to a Memme. What the hell?
      I can’t complain. Lela and I will be celbrating our 30th anniversary in April. I remember people at our reception at my parents house betting we won’t make a year. Who could blame them? Lela was just 19, Hey 19, and I was only 20 going on 14. We where 19 and 21 when our first son Michael was born. It was all a crazy time, but through much perserverance Lela and I have stuck together and our sons Mike and Pete turned out to be awesome kids.
      I find it funny that I started writing this blog in hopes of connecting with people who have had similar experiences in hopes of building a place where we could share our hopes, experiences, and struggles with each other, only to find my connections have been with friends I already know. I think it’s a reminder that what I am searching for isn’t very far away and that is a lesson I couldn’t have bought at any price, so how cool is that?

  1. Hi Jim, I’ve been dealing with afib for about six months, I had it for months before that but I didn’t know what it was. I don’t smoke, I play volleyball/wallyball vigorously, I’m not overweight, it couldn’t be my heart, right? I’m on flecainide and atenolol and baby aspirin. I can still play volleyball so that’s good news. I’ve asked about an ablation but doc doesn’t seem to think I’m an especially good candidate for it. Mary and I are fine otherwise, living on North Street in Waterville. Is Fast Breaks your place? I’ll hafta stop in sometime when I’m in the area!

    • Hey Mike. First off it is awesome you and Mary are together. I was reluctant to ask because sometimes people can be funny about that kind of thing if a relationship has ended. That means that you and Mary have been together for 33+ years. Very commendable in this day and age, even more so considering how young you both were when you first met.
      It is great that you have been able to stay active even with your arrhythmia concerns. I am familiar with the type of drugs you are taking. Flecainide is an antiarrythmic drug that helps keep your heart in a more stable rhythm. I take an antiarrythmic called Amiodarone. The Atenolol is a Beta Blocker that keeps the heart calm so it doesn’t get stressed when adrenaline juice, I believe that’s the scientific term, goes rushing through your body. It helps the heart beat smooth and gentle lowering the stress demanded from the heart. The generic Beta Blocker I take is called Carvedilol.
      Back in 2001 I had an ablation done at The Children’s Hospital in Boston. It was done there because my heart defects where congenital and they did my first open heart surgery there in 1966. Just a few short years ago. In 2001 I was struggling with paraxysmal atrial fibrillation. Which just basicly means it would start and start whenever it wanted to. For me the a-fib was symptomatic. After being put on a bunch of meds to slow my heart down I ended up needing a pacemaker to get it to beat enough. At that point they decided to try an ablation.
      The procedure was a piece of cake. It is like having a cardiac catherization done. For many patients it is done as a day surgery. Mine was a little more complicated because of all the scar tissue. They spent hours mapping out the electrical system of my heart. I ended up being in the hospital for three days.
      The ablation held my heart in rhythm for a little more than a month and then the a-fib came raging back. The doctors told me that because of the weakness of my heart it would continue to remodel to compensate for its diminished pumping and that continued growing of my heart made it so that any more ablations would only grant me a temporary reprieve just like the first one.
      My ablation experience turned out to be unsuccesful, but it was a simple easy experience so I wasn’t too discouraged at the time. I have had three or four friends that had ablations whose hearts were more normal than mine and their experience was completely different. The procedure not only stopped their arrhythmias, but they were able to come completely off all their heart meds. Out of the all of them not one of their hearts went back out of rhythm and one of them was done over eight years ago.
      Lela and I do own Fast Breaks. I am hardly ever there now due to my continuing bad health. Lela has taken over running the place now and after only short learning curve she has wrestled the business back onto a solid foundation. It got hard as I got sicker, but she has been a rock that has not only taken control, but has continually improved the business.
      It is great to hear from you. I hope you will stay in touch and maybe someday soon the four of us could get together. We do occasionally go up to Waterville so maybe we could grab a bite to eat.

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