Q&A with Patrick J. Fox
On March 31, 2008, Patrick Fox, a relatively healthy, 48-year-old defied the odds and death six times when he suffered a "widow-maker" heart attack. One year later, Fox wrote The Widow-Maker Heart Attack at age 48, a book that provides hope and a pathway to recovery for other heart attack patients and their loved ones facing the same daunting, life-changing, unexpected experience. The book chronicles Patrick's first year after the heart attack, and, in his words, "has a great deal to relay about heart disease, surviving heart attacks, anticipating heart attacks, and mentally and physically recovering from heart attacks." He is considered a 'medical miracle' by many health professionals, and that accomplishment encouraged him to share his story with others. Patrick can be contacted at firstname.lastname@example.org.
You say you've never written anything before. What made you write about this experience?
My daughter and son and my wife looked and looked for books on heart attacks in relatively young people, especially what's known as the "widow-maker" heart attack, and almost 100% of the books they found were written by medical professionals, not by survivors. They were good, but not what my family was looking for in terms of what I was going through and what they wanted to know. It may sound corny, but it seemed like a higher power pushed me to write it.
Describe what happened on March 31, 2008, and how you reacted.
At the time, I was a high-school teacher in Rockford, IL. About 8 a.m. I was doing grades for the third quarter when I started feeling some discomfort in the very tips of both of my shoulder blades. The day prior I had been chain-sawing trees and throwing around 50-pound bales of hay, so I thought it was muscle-related. I started running around the room and doing jumping-jacks, push-ups and arm-rolls to try to loosen up my shoulders. Looking back, that probably wasn't the brightest thing to do, but I never thought it was a heart attack because it wasn't what I call a "Hollywood heart attack" with left arm pain and throwing up. I didn't connect the dots. The pain grew worse, so I asked the school nurse for some Advil, which helped for about 30 minutes, then the pain came back with more intensity. By 9:10 the pain was unbearable, and I agreed that an ambulance should be called. The paramedics put me into the ambulance and I told them what I'd been doing to get rid of the stiff muscles and which hospital my insurance provider preferred, and suddenly I coded. I came back just as they were taking me out of the ambulance and remember holding onto the gurney for dear life and thinking, "My goodness, it's just a back problem."
When did you finally realize something more serious was going on?
I didn't have a clue until I woke up in the ICU with a tube down my throat and feeling like a gorilla had jumped on my chest. That's when I realized it was not just back pain. In addition to the first episode, I found out I had coded in the emergency room, in the hallway between the ER and the cath lab, and in the cath lab--a total of six times. I remember a nurse rubbing my cheek and saying, "Don't leave us again," and I was clueless what she was talking about. Later, my cardiologist came in, and when I asked him what happened, he said, "You weren't just a little bit dead; you were way dead." That was difficult to hear. People I've talked to since assumed the doctors cracked open my chest, but I tell them I wouldn't be here today if they'd taken time to do that. They had one chance and they took it, because they couldn't keep me alive. God was in that cardiologist's hands--there's no two ways about that. (Patrick had angioplasty to clear a 100% blockage in the left anterior descending artery.)
One of the experiences you remember clearly was how you reacted the first time you were given nitroglycerin. Describe what that was like.
It was like someone hitting me in the head with a heavy baseball bat. It was brutal. It would be good if the EMS or ED personnel could give patients some idea of what it might feel like--that it might give you a headache or make you feel queasy--just a checklist of possible feelings, because it made me think I was having another heart attack. I've taken nitro since then and it hasn't been as profound, but the first time was one of those things you don't forget.
After you were released from the hospital, you say you suffered from severe depression and couldn't watch TV shows or commercials that portrayed heart attack victims.
The nurses at the hospital tried to tell me that might happen, and I didn't believe it. I was wrong. My experience was very traumatizing emotionally. Depression is very real, and heart attack survivors shouldn't think it can't happen to them. I'm still dealing with it, although it's not as severe as it was. I can now watch shows like Grey's Anatomy and the Plavix commercials, but I still occasionally have mental setbacks.
What reaction have you had to your book?
Most of the response has been through my blog and the website. The unfortunate thing is that I was so driven to get it done, I self-published it, so it hasn't gotten as much attention as it might have through a publisher. It's a slow-growing acceptance, but over time, the people who need it will find it, and that's the important thing. There's one thing I regret not putting in the book that I should have and that's to say that the paramedics who took care of me came to the hospital a few days later to see how I was doing, and that was very special. I think the value that patients get from EMS following up on them is priceless.
I'm a living miracle survivor of a massive heart attack. My book has a lot to say about heart disease, surviving and anticipating a heart attack, and mental and physical recovery from a heart attack.
"The more time I spent awake, the more worried I became about my physical well-being. I could not communicate verbally to discover why I was hooked up to all of the machines. I began discovering how quickly life changes. I thought to myself that I am forty-eight years old, healthy, active, with a great diet--this entire experience does not add up.
I felt totally confused and helpless, especially since I could not ask how bad the situation really was, which only compounded the overwhelming emotions. My heart and emotions started to flounder like a struggling horse stuck in mud. My life was completely out of my control, which is a terrible feeling. I so badly wanted to get up, get dressed, get the heck out of the hospital. I felt like someone had pushed the fast-forward button on my life and it was racing out of my control. Worst of all, I could not verbally communicate to my family that mentally I was OK and lucid, and what the hell was going on? I wanted my wife to know that I was still there mentally but could only communicate with my eyes.
As much as I tried to communicate with my eyes, I failed in a big way. As the frustration rose to very scary heights, I felt a physical frustration that I have never in my forty-eight years of life felt before. As the frustration mounted, as I am sure my blood pressure did as well, my physical body started to do uncontrollably scary things. As my feeling continued to return more and more, I realized that my breathing was not as fluid as I had for so long taken for granted. I felt a haunting feeling that I was unable to breathe. I could not take that cleansing deep breath that had become a part of my daily ritual for calming down.
I was able to motion my wife and nurses that I wanted to write down feelings and needs on a piece of paper. I found myself laughing internally when all they could find for my writing was a small, almost Post-it note-size tablet. However, my wife claims that was a full size pad of paper. While it may not have been noticeable to anyone else, I wanted to ask out loud with a great deal of sarcasm, "Do you think you could find anything else smaller for me to write on?"
The anxiety of not being able to speak when waking up and becoming cognizant of surroundings is incredibly scary. In my opinion, hospitals should make available to each patient a method of communication by actually handing them a pad of paper and a pencil. The more I struggled to communicate that I wanted a pencil and paper to communicate, the more I became frustrated and angry. Not a good thing, given the situation.
It was then for the first time out of the wild-blue yonder that I inexplicably and with no warning of the slightest nature vomited for the first time. I vividly remember looking at my wife first and then at the nurses who were tending to my medical needs. My emotions took a very abrupt turn south and my emotions hit new lows. It was at this point that everything seemed to go into slow motion.
I suddenly felt every bad thought that I probably could have thought at the time. I was struggling to breathe, the discomfort in my chest was mounting, sensors were hooked up everywhere, and tubes seemed to be stuck in my arms more than ever before in my life--and now the ultimate icing on a dreadful cake. I was vomiting uncontrollably without warning and could not function normally. I found myself looking at everything the doctors had attached to my body, and I lost it emotionally and wanted to rip out every medical device attached to me. I wanted life to return to where it was earlier in the day. I wanted to teach like I do every day. This really sucked.
It was about then that my daughter, Stephanie, and son, Brandon, walked into the room. I desperately wanted to hold them tight in my arms and tell them that I was okay. It was then, to the best of my recollection, that I threw up for the second time. I realized that I was totally coming unglued emotionally. I was hooked up to lots of things, I was already struggling with the breathing program, and my chest was feeling rather uncomfortable. I had already been totally embarrassed from the original aspiration, and now with my daughter and wife standing nearby, I threw up for the third time. What that, my daughter jumped back and ran out of the room. I was devastated, and my level of being scared went much higher as I saw her run out of the room.
It was then that breathing became difficult at best, or to put a finer point on it, "damn difficult." I began to feel as though I was starting to suffocate or drown right in front of my loved ones' concerned and worried eyes and that I had no control over the situation. I looked into the eyes of my wife and for the first time since leaving the cath lab I realized that maybe I was not going to make it, and I just wanted to scream to her how much I loved her as I struggled to breathe.
It was then that I heard the statement from the medical staff that I needed an NG tube up my nasal passage. For anyone who is wondering about the feelings related to the insertion of an NG tube, let me say it in laymen's terms: it hurts like a son of a bitch! The pain level for insertion of that godforsaken tube went way past the one-to-ten scale of pain. To put it in perspective, I would rather have a catheter inserted and extracted from my genitalia five times than to ever have an NG tube inserted once while I remained awake.
I thought for sure that I was on death's doorstep. The eye language of my wife and daughter, as much as they tried to put on a happy face, failed to eradicate the doorstep thought. My breathing became more difficult before it got any better from the insertion of the NG tube. I am sure that it helped in reality, but in my reality it did nothing but make me feel like I was suffocating in a slightly slower death."