July 2010

The following day, Friday I was wheeled into O.R. about 12:30pm. The procedure was 7.5 hours. I became conscious about 9am Saturday morning in Intensive Care. When I saw my surgeon three week after surgery at his office in La Jolla I was told that when the removed the clot everyone in the Operating room were stunned by its size and they took photos, which I knew I must have. The clot remove ONLY from the left ventricle was 5.5cm X 3.3cm X 1.5cm and weighed 20 grams. Some research I have done is that it appears this clot was at least 1.2 times larger than the ventricle. So it was stretching the walls of the ventricle.

I also found out at the post op meeting that my ‘silent’ heart attack was so damaging that my left ventricle hardly pumps anymore. That is why plaque built up in there. I was told that a ‘regular’ diet is no longer a possibility for me because if I consumed the average fats per day a health adult would consume, my heart no longer had the capability to discharge it to the liver. Go to next page

Most of 2010 had been an extremely productive year conducting numerous biological surveys for various clients and kept me doing field work 7 days a week from March 1st thru June 30th. In between I co-authored a scientific paper with a colleague and took part in a couple scientific presentations about particular areas where I was studying a couple species of butterflies. Many of my professional acquaintances noticed I was losing a lot of weight but one close friend said I looked extremely pale, which was unusual since being outside I would have a tendency to get a decent tan.

When July began I could begin slowing down and was taking advantage of updating my database of birds, plants and insect observations from my field notes. On Saturday, July 17th, my partner had some bird watching with a friend along the San Diego River Channel by the ocean in the late afternoon. I mentioned I was headed out for some Mexican food. He wanted something also and he took off. I went got some food. I had a chicken bowl and was full. I was very tired and rested for about an hour and then went back to my computer and attempted to open the database software and was surprised it would not open up. Eventually I realized I was double clicking the Desktop instead of the database icon. When I opened the database I went to enter a bird name and looked at my keyboard and could not understand it at all. I thought someone change the keyboard with another language. I tried for over 10 minutes to type in Northern Mockingbird. For the life of me I could not spell Northern. I was completely lost. So I gave up and figured out how to get to my insect database and attempted to enter Western Tiger Swallowtail. I could not spell Western. Again I was completely lost. I was certain the keyboard was wrong. The problem was, ME.

So I gave up and turned off the computer and went to bed. I did not sleep well at all that night. I got up Sunday morning got the Sunday paper had a cup of coffee and I could not understand the paper. I tried reading the comics and nothing made sense or was funny. I again tried to work on my Database in my computer and had the same problem. I could not spell anything. I thought it was dinner from the previous evening but I was never sick to my stomach. Frustrated I gave up on the Database and turned off the computer and laid in bed and watched TV the rest of the day. TV was different. I watched it but could not follow any story lines and these were previous movies I used to see.

Monday came around and everything was the same or worse. By the end of the day my Partner finally asked me if I was OK. I got a stuttered, ‘NO’ out of my mouth He told me I was slurring my words and I was never completing sentences. In my mind I was convinced I was. Since it was late in the day my doctor was not going to be available assist so we decided to call him first thing Tuesday morning. I was worse on Tuesday and now I was beginning to forget things. We left a message with his nurse about my condition and he was slammed with lots of patients that morning and could not get back to us for about 2 hours. Once my partner explained everything to him he told my him to get me over to the emergency room and my doctor was calling them letting them know I was on my way. What went through my mind when I heard this was, I was going to have sit in the waiting room for hours. A year earlier I took my partner to emergency for a kidney stone and he was in extreme pain and we sat in the waiting room for over 8 hours. So I thought, ‘Oh boy, I am going to be in the waiting all afternoon into the evening.’ Well when we got there my partner told the nurse who I was and they said, ‘Oh yes, your doctor has already called and we have been expecting you.’ I was immediately put into a wheel chair and sent to an ER bed. My partner handled the paperwork. All I recollect at that point was a swarm of nurses and doctors coming to my bed doing all kind of visual and physical test. I was put on a monitor and an EKG was done. I was wheeled over to radiology and I have no idea what they were doing and then wheeled back to my ‘room’.

Eventually a doctor came in, introduced himself and did another quick series of physical tests on my arm strength and legs. Then things all of a sudden slowed down for me. I recollect a handful of nurses and 2 doctors as well as my partner around my bed. The doctor who checked me sat down in front of me and asked, “What is your birthdate?” I had a blank stare and thought and thought and finally I realized I did not know when I was born. I tried to say something but nothing came out so I shrugged my shoulders. He then told me I was in Scripps Mercy Hospital and asked if I understood. I tried to say something but nothing would come out. So I nodded my head that I understood. So he then asked me where I was. I thought and thought and I did not know where I was so I shrugged my shoulders. He repeated where I was at and then asked my telephone number. I could remember and I could not tell him. I tried to say something but nothing would come out so I shrugged my shoulders. He again asked me where I was. I thought and with a lot of effort I finally said “bed’ in a very slurred speech. This went on with a few more questions and he was telling me I was in Scripps Mercy Hospital. Each time when he asked me I could not remember anything. Eventually I began to cry. I did not know what was going on and in the emotion I was able to get out slurred words that I did not know what's wrong with me. The doctor stood up placed his hand on my shoulder and said, “Son you’ve had a stroke.”

Another interesting point is I was told in ER that the EKG showed I had a heart attack. The nurse said they could not tell when it was but it clearly showed I had one. I learned months later that the equipment used in my primary doctor's office has only 4 leads and usually will not provide everything that a machine with 8 or more leads. This is why I am convinced that in 2000 I had my heart attack.

So I was admitted to the hospital and cardiology got involved and I was scheduled for an MRI the following day. I had a head MRI and when the Neurologist saw the results he called in 3 of his colleagues to get their opinion on the MRI. My head had thousands or mini-clots floating randomly throughout my brain. The conclusion was only one would need to hit certain areas and at best I would become a vegetable. Cardiology was brought in because Neurology said these clots need to go but wanted to understand where they came from. So Cardiology scheduled a heart MRI on me. When those results came in a Cardiac Surgeon came into my room. Now I was still in bad shape with retaining memories and comprehending what was happening to me. However, with a surgeon coming into my room I concluded it was serious. I was told the MRI showed an extremely large growth in my left ventricle. The doctor said that based on its size he and others were leaning to a tumor. But they wanted do an ‘Angio’ and send a camera up my vein to confirm this.

The following morning I was sent to another room and they ran the camera into a vein in my thigh. Those who are unaware of this procedure, you are alert and wide awake for this. So even I could see monitors. When the camera entered the left side of my heart one of the interns saw the growth and I heard “Whoa”. Now even though I was still under the effect of the stroke, my mind comprehended that term. When the procedure was completed the resident Cardiologist gave me the immediate results and told me that I did not have a tumor but it was the largest plaque (fat) clot he had ever seen in his career.

So now on Thursday evening (2 days in the hospital) we were visited by the surgeon again. He explained options I had. I could go home and be placed on large amounts of meds with a hope the clot would break apart. However he noted that based on what the ‘Angio’ showed the texture of the clot was ‘leathery’ indicating it was old. Since all these tests confirmed I had what was coined a ‘silent’ heart attack meaning no one knew when it occurred but that it was over 5 years ago based on the leathery texture of the clot. (side note: remember what the Cardiologist said to me in 2000 that my left ventricle was not retracting properly. I am certain that September 2000 is when I had my heart attack). If I went home there was less than a 30% chance the clot would break up and with clotting material already in my head I had over a 90% chance of recurring strokes until the clot material is removed.

My second option was to have emergency surgery the following day (Friday) to cut open the heart and remove the clot all at once. Also with some material in my head the Heart MRI showed that I also needed a triple by-pass. I was told my chance of coming off the table alive was a 50/50. He indicated the risk was the clot in my left ventricle and he could not get to it from underneath because my diaphragm was in the way. Therefore he must go through the top, cut open the heart to reach the clot. Also the clot was just so large he did not know if he would get it all at once and having to continue going into my heart to keep taking pieces of clot out puts me at even greater risk.

So here I was not being able to retain memories because of the clot. Risk of regular strokes until the clot is gone. I may not make it off the table. So I went with intuition. What made me ‘feel’ comfortable was to chance the table. A friend of ours was in the room visiting when this was given to me and I spoke with difficulty to her and my companion and they also agreed the risk was better on the table.