Sunday, March 5, 2017

Having A Heart Attack? The Durham VAMC is Tough to Beat.


I've had heart issues going back to 2006 when I had a mild heart attack that was a result of being in a diabetic coma. While it happened again two more times in 2015, numerous tests showed no lasting impact. In fact, just a few weeks ago I checked with my cardiologist to see if there were any concerns from his standpoint about having elective surgery. There were none. I have had chest pain all along, but my cardiologist said it was of no concern, but he was careful to remind me of the symptoms of a heart attack and to take appropriate action if they occurred.

Then last week the usual chest pains seemed to be a little bit different. They weren't dramatic or greatly concerning - just simply annoying. But now they came with a twitch of pain in my left arm, and a mild twinge now and then between my shoulder blades. While no big deal separately, add them to together and while the pain was a 2 or 3 on a scale of 10, they got me to thinking that I should talk to somebody smarter than I.

The obvious choice is to go to the Emergency Room. When all you have for healthcare is the Veterans Affairs, that choice isn't exactly simple. If I went to a non-VA ER and my problem was not a true emergency, the VA might not pay for it and leave me on the hook for whatever that visit might cost. That amounts to a pretty big roll of the dice, and I'd been stuck once before, so unless somebody else made the call, i.e.: an EMS crew, then I was going to the VA's ER.

In my case, the nearest one is in Durham, NC - a one-way trip of 65 miles. I was feeling cruddy, wasn't sure it was an emergency, so off I went.



I checked into the ER at 3:44. I gave the clerk my symptoms, got an wristband and took a seat. I cracked open my novel and prepared to wait. Before I finished the second paragraph, they called me back. A nurse catalogued my symptoms, took my vitals and hooked me up to an EKG. He gave me some aspirin, drew some blood and returned with a doctor.

The MD said my EKG was concerning and I was hustled off to a treatment room. I hadn't had a chance to get comfortable before a nurse came back with the blood results. A Troponin test came out at 6.56 - at 0.5 one is assumed to be having a heart attack.

Before I knew it, a half dozen doctors and nurses came out of nowhere. Very quickly they concluded that I needed to immediately have a cardiac catheterization done to identify and clear any blockages of arteries that feed blood to my heart. In other words, I was right in the middle of having a heart attack.

There was no wasted motion, panic or confusion. Clearly they knew exactly what had to be done, the role each would play and that time was essential to a good outcome. They took me to the OR, ran a device into my arm and up to my heart. They injected die that showed up on a computer screen that showed exactly where the blockage was. Next they expanded a balloon to reopen the artery and inserted a sleeve made of wire mesh to keep it open. They repeated that again for a second artery and said the problem was solved. The entire procedure took just 45 minutes and I was wheeled out of the OR and up to the Cardiac Intensive Care Unit two hours and one minute after I'd walked into the ER.

After getting situated in the CICU, the next order of business: dinner.

Much has been said in the media attacking the Durham VAMC ER for poorly treating 3 veterans the week before my visit. I don't disagree that one callous employee dropped the ball. But like any other large organization, all it takes is one knucklehead to do something dumb once to taint the hard work and professionalism of hundreds who do the right thing all the time.

I'll tell you this: I owe my life to the skill, dedication, compassionate care and professional excellence of the men and women of the Durham VAMC. They serve veterans well and provide fine service that we can all be proud of. Sadly, that isn't the kind of story that attracts media attention, or is celebrated by so-called "Concerned Veterans." While I'll admit that there are things that annoy me that could be done better, I wish that their success stories (like mine) were more widely publicized.

To the men and women of the Durham ER, CICU, Cardiology and Endocrinology Departments: my family and I thank you.

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