Compassionate Medicine
By David Dennis
I don’t consider myself a hypochondriac; I don’t diagnose myself with COVID or cancer when I get the sniffles or a belly ache. However, when a vice grip grabbed my heart and shot ripples of pain into my ears, I became worried. At seventy-one, I expect to encounter more physical limitations and ailments, but unlike a beat-up old vehicle, I can’t trade my body in for a newer model.
I began this medical journey by pretending that nothing was wrong —classic denial. When the second episode hit a week later—I chalked it off to indigestion or acid reflux (which I don’t have). Finally, when episode three hit, I fessed up to my wife and a few friends. Most of them used the words like “idiot” for not going into the doctor after number one - though I must admit, there was compassion and love alongside this harsh but accurate assessment.
So off to my trusted general practitioner I went. He said there may be nothing serious to worry about, but priority number one is to rule out the serious possibilities. He dialed up the cardiologist who had evaluated my heart prior to my prostate surgery six years earlier, and I had a next-day appointment to begin the evaluation process.
The cardiologist agreed with my family doctor and scheduled me for an angioplasty two days later at an excellent Guadalajara hospital. As I left his office that Saturday afternoon, he gave me a very stern order. “Should another episode occur before Monday,” he said, “call the surgeon I referred you to on his cell phone and he will perform the procedure immediately.”
At 7:30 am Monday morning, we climbed into the car of our driver, who navigated rush-hour traffic in Guadalajara and got us to the hospital in one piece. I had no fear of the procedure because I’d done my homework and was reassured of our surgeon’s excellent credentials and experience. I had plenty of fear, however, about what all this might mean to my future well-being.
After completing a COVID test and a plethora of hospital paperwork, I donned one of those lovely hospital gowns and lay down on a gurney with an IV in my arm. The surgeon appeared and spent all the time I needed to hear about the procedure and ask my many questions. When I told him I wanted to be fully anesthetized, he let out a kind laugh and said, “We don’t do that here because I need you awake to hold your breath and breathe shallowly when I remove the catheter.”
As it turns out, I am glad I was fully awake. The operating room had an amazing array of sophisticated instruments and blinking lights. After scrubbing my right arm with an ugly orange antiseptic, the doctor brought out a syringe to deaden the area around the targeted vein in my wrist. He said it would be the most painful part of the procedure, but he promised it would be no worse than a dentist’s Novocain shot. After ten seconds of jabbing, the doctor asked, “That wasn’t so bad, was it?” I responded with, “You’re fired.” We both laughed as he cut the vein and inserted the catheter.
He talked me through every step of the 20-minute procedure. I felt slight pain as the catheter worked its way up my arm. As it closed in on the heart, a flush of liquid was released that produced an odd sensation—I presume it was the dye that would allow the imaging system to identify blockages and a host of other problems that might be present. A large rectangular gizmo hovered about three feet above my heart. It moved from side to side and back and forth at various angles and sent a signal to the TV monitor alongside my bed.
And there it was, live and in color —a real-time view of my beating heart and its surrounding, pulsing arteries. After a short amount of time—short enough so my fears didn’t turn into abject terror—the doctor announced to his team, and me, that he didn’t need to do anything. My worst occlusion was only 20%—an excellent outcome, he said, for a seventy-one year old. I did not need a stent because they are only used when the occlusion levels are above 70%.
So what was the problem? He showed me a relatively minor artery on the screen that was partially blanketed by a muscle. This could be the reason for my episodes because it can cause a painful constriction from time to time. He assured me it was not at all serious —and more importantly, it was neither dangerous nor potentially fatal.
And better yet, based on the 25 diagnostic components that the angioplasty evaluated, my probability of a heart attack in the next five years approaches zero. All I need to do is take prescribed medication for three months and reduce my intake of coffee (painful, but doable).
I’m a happy man. I hope I never have to visit a cardiac surgeon again, but if I do, he’s the guy. He demonstrated to me the very definition of compassionate medicine.
For more information about Lake Chapala visit: www.chapala.com
