Post Op Day 8, The Crash

I got off the phone with my Cardiothoracic surgeon and sat quietly for a second letting the news sink in. I was just told the pathology results, that the port to treat my Lyme Disease was probably the cause of all the past two weeks of pain and suffering. The mass was a large clot, either from the tip of the port or possibly a blood clot disorder they would test for later on when I was recovered. My breath felt labored and I began to feel nauseas. I felt my heart pounding hard in my chest, and fumed about this news. Within minutes I began to decline. I scooted tenderly to the front of the chair, thinking I should go to the bathroom. I told my mother I needed some anti anxiety medicine, and thought I was having a slight panic attack. 'How dare I get myself so worked up over something so trivial', I thought to myself. By the time my mother walked to my room to grab the anti anxiety medicine, both of us thinking I was just upset, I worsened. I grabbed the first thing to throw up in, a cardboard box on the couch next to me, and hugged it to my chest, feeling myself breaking out in an immediate cold sweat. I became so dizzy and weak that I fell backwards into the chair, and turned white as a ghost. My mother returned with a confused look on her face. "What's wrong?" She said, seeing my condition diving fast. She felt the immense sweating and knew immediately this was not simple panic attack stuff. I barely managed to say "something is really wrong, call 911" as I felt myself slipping into the black. She grabbed the blood pressure cuff and the electric machine read 'error', unable to register a pressure as it dropped so severely low. I remember thinking, as people bustled around me, 'wow, I feel terrible. I'm sweating. There's no pain but I think I'm having a heart attack. I don't think the EMT's will make it in time. So, this is what it's like to die? It's happening pretty quickly, a minute ago I was fine.'

I don't remember a section of time as my breathing stopped, and my mother shook my hands to try and keep me with her. I don't remember staring blankly into midair in an unconscious stupor. The paramedic arrived as I was slowly coming to again, my oxygen reading at 60, temperature under 90 degrees. The blood pressure was so low that I was unable to get oxygen to my brain, and I was struggling to make eye contact or understand what was happening. My mother did not allow the rescue team to move me, as they reached for my arms. She protected my sternal incision by pushing them away and helping me move my own weight to the stretcher. Once I was settled on the stretcher I was not moved again except by sliding a sheet to and from surfaces. I begged them not to hurt my chest, still sensitive from a week before when I had the open heart surgery. The got me in the ambulance, placed an IV and began an EKG and all my vitals which were gradually settling back to safe levels. I was becoming more aware of my surroundings and discussed with the paramedic my condition, the syncopal episode, while on the drive to the hospital. She suspected septic shock, maybe from an internal infection. I was wheeled into the emergency room at LRGH and immediately seen by doctors and nurses and machines of different types. They quickly ran a few EKGs, seeing unnatural rhythms, and ran a chest X-Ray in the bed. The doctor got the portable ultrasound machine and placed it on my chest, as nurses bustled around me poking and prodding. I was vaguely aware of the violation of my body, where hands made themselves at home and eyes traveled my scars for signs of problems. My surgeon was phoned about my condition, and a decision was made to transport me by helicopter to Dartmouth as the quickest option. I was no longer in a stable condition, within fifteen minutes I had declined yet again to unhealthy vitals, extreme nausea, and the doctors discussed my echo pictures over me while I wavered in and out of attention. My mother and father were there with me in the trauma room, and a herd awaited in the ER waiting room from the news of my condition. I was listed in critical condition, but my grandparents and boyfriend got to come in one at a time and pray with me and say hello briefly. I don't even remember the faces coming and going, words that were said, things that were done. Apparently I even told my mother I needed to say goodbye 'one last time' and 'don't let them bring me back to Dartmouth, it's so far away'. I knew my situation was serious, but I had no idea how serious. Recounting the events later, I was informed that I had leaned forward to throw up and passed out cold again (every time I sat up my blood pressure dropped to the point of loss of consciousness, which the ER did not pick up on). The doctor yelled for beta-dine, and my mother and boyfriend were rushed out of the area along with another nearby patient. On their way out, they heard the two doctors peering over the ultrasound picture discussing a collapsed right ventricle (known as cardiac tamponade) and fluid on the heart (pericardial effusion). I pulled out of the black abyss slowly, and cried 'where am I?' before looking down. I saw my orange stomach and the young doctor hovering a large needle only three inches above my sensitive skin. Immediately panic set in and I screamed and flailed. "You are not touching me with that, I'm awake now, don't touch me, please use Lidocaine," I cried loud enough for the entire hospital to hear. Someone dug in my left arm for an IV access and as my blood pressure rose. Right at that moment the DHART helicopter response team strolled in to see the chaos. They cleared out the room, gave up on the second IV possibility, and demanded Lidocaine for my comfort in case of a future emergency pericardial drain procedure. Ativan was administered to calm me before the flight, and my condition was stabilized. These few men took control of the situation, kept my needs met, and saved me from a traumatizing situation. I stil view them as angels as I recollect the face of the head paramedic in my mind. I will never forget his first action, where he grabbed my hand and announced with confident 'I am Kevin, I am going to take good care of you, what can I do to make you more comfortable?' As I was rolled out, half way aware of what was occurring, I got to say goodbye to the lineup of family that had formed. My parents first, then my grandparents, Robbie with his unsure look of concern, and an aunt and uncle with their children, all yelling well wishes and patting my arm as I passed, on my way to a small green helicopter waiting to escort me in style.