The Loopy Aficionada

by Jane Hirshfield

Everything has two endings-- a horse, a piece of string, a phone call.

Before a life, air. And after.

How the Grinch Stole Christmas (2000) dir. Ron Howard

I am an ER nurse and this is the best description of this event that I have ever heard. 

 FEMALE HEART ATTACKS 

 I was aware that female heart attacks are different, but this is description is so incredibly visceral that I feel like I have an entire new understanding of what it feels like to be living the symptoms on the inside. Women rarely have the same dramatic symptoms that men have… you know, the sudden stabbing pain in the chest, the cold sweat, grabbing the chest & dropping to the floor the we see in movies. Here is the story of one woman’s experience with a heart attack: 

 "I had a heart attack at about 10:30 PM with NO prior exertion, NO prior emotional trauma that one would suspect might have brought it on. I was sitting all snugly & warm on a cold evening, with my purring cat in my lap, reading an interesting story my friend had sent me, and actually thinking, ‘A-A-h, this is the life, all cozy and warm in my soft, cushy Lazy Boy with my feet propped up. A moment later, I felt that awful sensation of indigestion, when you’ve been in a hurry and grabbed a bite of sandwich and washed it down with a dash of water, and that hurried bite seems to feel like you’ve swallowed a golf ball going down the esophagus in slow motion and it is most uncomfortable. You realize you shouldn’t have gulped it down so fast and needed to chew it more thoroughly and this time drink a glass of water to hasten its progress down to the stomach. This was my initial sensation–the only trouble was that I hadn’t taken a bite of anything since about 5:00 p.m. 

After it seemed to subside, the next sensation was like little squeezing motions that seemed to be racing up my SPINE (hind-sight, it was probably my aorta spasms), gaining speed as they continued racing up and under my sternum (breast bone, where one presses rhythmically when administering CPR). This fascinating process continued on into my throat and branched out into both jaws. ‘AHA!! NOW I stopped puzzling about what was happening – we all have read and/or heard about pain in the jaws being one of the signals of an MI happening, haven’t we? I said aloud to myself and the cat, Dear God, I think I’m having a heart attack! I lowered the foot rest dumping the cat from my lap, started to take a step and fell on the floor instead. I thought to myself, If this is a heart attack, I shouldn’t be walking into the next room where the phone is or anywhere else… but, on the other hand, if I don’t, nobody will know that I need help, and if I wait any longer I may not be able to get up in a moment. 

I pulled myself up with the arms of the chair, walked slowly into the next room and dialed the Paramedics… I told her I thought I was having a heart attack due to the pressure building under the sternum and radiating into my jaws. I didn’t feel hysterical or afraid, just stating the facts. She said she was sending the Paramedics over immediately, asked if the front door was near to me, and if so, to un-bolt the door and then lie down on the floor where they could see me when they came in. I unlocked the door and then laid down on the floor as instructed and lost consciousness, as I don’t remember the medics coming in, their examination, lifting me onto a gurney or getting me into their ambulance, or hearing the call they made to St. Jude ER on the way, but I did briefly awaken when we arrived and saw that the radiologist was already there in his surgical blues and cap, helping the medics pull my stretcher out of the ambulance. He was bending over me asking questions (probably something like ‘Have you taken any medications?’) but I couldn’t make my mind interpret what he was saying, or form an answer, and nodded off again, not waking up until the Cardiologist and partner had already threaded the teeny angiogram balloon up my femoral artery into the aorta and into my heart where they installed 2 side by side stints to hold open my right coronary artery. 

I know it sounds like all my thinking and actions at home must have taken at least 20-30 minutes before calling the paramedics, but actually it took perhaps 4-5 minutes before the call, and both the fire station and St Jude are only minutes away from my home, and my Cardiologist was already to go to the OR in his scrubs and get going on restarting my heart (which had stopped somewhere between my arrival and the procedure) and installing the stents. Why have I written all of this to you with so much detail? Because I want all of you who are so important in my life to know what I learned first hand. 

1. Be aware that something very different is happening in your body, not the usual men’s symptoms but inexplicable things happening (until my sternum and jaws got into the act). It is said that many more women than men die of their first (and last) MI because they didn’t know they were having one and commonly mistake it as indigestion, take some Maalox or other anti-heartburn preparation and go to bed, hoping they’ll feel better in the morning when they wake up… which doesn’t happen. My female friends, your symptoms might not be exactly like mine, so I advise you to call the Paramedics if ANYTHING is unpleasantly happening that you’ve not felt before. It is better to have a ‘false alarm’ visitation than to risk your life guessing what it might be! 2. Note that I said ‘Call the Paramedics.’ And if you can take an aspirin. Ladies, TIME IS OF THE ESSENCE! Do NOT try to drive yourself to the ER - you are a hazard to others on the road. Do NOT have your panicked husband who will be speeding and looking anxiously at what’s happening with you instead of the road. Do NOT call your doctor – he doesn’t know where you live and if it’s at night you won’t reach him anyway, and if it’s daytime, his assistants (or answering service) will tell you to call the Paramedics. He doesn’t carry the equipment in his car that you need to be saved! The Paramedics do, principally OXYGEN that you need ASAP. Your Dr. will be notified later. 3. Don’t assume it couldn’t be a heart attack because you have a normal cholesterol count. Research has discovered that a cholesterol elevated reading is rarely the cause of an MI (unless it’s unbelievably high and/or accompanied by high blood pressure). MIs are usually caused by long-term stress and inflammation in the body, which dumps all sorts of deadly hormones into your system to sludge things up in there. Pain in the jaw can wake you from a sound sleep. Let’s be careful and be aware. The more we know the better chance we could survive to tell the tale.“

In addition to all this, please keep in mind that everyone experiences differences when they have a heart attack as not all heart attacks are the same.

My aunt had a heart attack and she said she had none of the warning symptoms she knew about. She felt like she was coming down with a flu, went to lay down, a bit later she said she felt like she was going to throw up, so she ran to the bathroom, threw up, still had no other symptoms but she went into the living room and passed out cold on the couch.

Luckily her mom was there and called an ambulance, and she pulled through it after have 3 heart attacks that weekend.

She said her only symptoms she got was a feeling of slight numbness like you get when you’re getting a flu, and severe nausea.

Alternatively, one of my relatives (unsure the relation) was perfectly fine, said he was going to go take a shower to go out with some friends, got half way across the living room and collapsed. He was dead before his mom even reached him) Not saying this to scare anyone. But they’re all different.

Letters. You don’t really write many these days, do you? But I bet there’s one you never forget. Send it off to a certain plump guy in a red suit and, provided you’ve kept your act together more or less, he’ll drop off a toy or two. And yet, no one seems to wonder how the whole thing got started in the first place.