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.
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.
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.