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It wasn’t “Just Another Manic Monday” for 45-year-old Marie Bonetti (not her real name). Marie had just gotten out of the shower when that nagging pain returned in her upper abdomen. The intermittent pain with severe indigestion had been recurring for the past several months and her primary care doctor was trying to “get to the bottom of it”. She had an upper GI, testing for gallstones, testing for pancreatic enzymes… all were negative. “I was due to have a lower GI the following week” Marie recalled. “I think my doctor was a bit surprised not to find an ulcer. He knows what kind of stress I’m under. As a single mom of two teenagers, I worry constantly about making ends meet. I’ve been divorced for over 9 years and it's still very tough financially. Perhaps I deserve to have a stomach ulcer –– but that's not what was causing my pain.”
Marie is a clerk-typist at the county courthouse where she has made alot of friends over the past 10 years. She remembers feeling especially rushed that Monday morning as she had to drop her daughter off at the car dealer's. If she was a few minutes late, her boss would understand. Eighteen-year-old Angeline lived at home while attending community college. Her son, also a college student, lived nearby in an apartment but still depended upon mom to help out with truition.
“We have to leave right now, Angeline, or I'll be late for work. Are you ready to go?” Just then, Marie bent over with severe pain in her upper chest. She could barely breathe and had trouble talking but she was able to call out to her daughter in a strained whisper “Angeline! Call my doctor right now! I'm having chest pain!”
Angeline pleaded with her mother. “We need to call 9-1-1, mom. You're having chest pain. It could be a heart attack!” Marie admits that she, too, thought it was a heart attack at that time, but, for some reason, she simply did not want to call 9-1-1. “Angeline, CALL MY DOCTOR RIGHT NOW”. Angeline called her mother’s doctor who advised she go directly to the emergency room. When she refused, he advised her to come to the office immediately. Angeline drove her mother to the doctor’s office that was located just 2 miles down the road. The doctor took one look at Marie with her ashen color and shortness of breath and called 9-1-1. The ambulance arrived within minutes and soon, Marie found herself in the emergency room of the local heart hospital.
“I got the best of care at that hospital. The cardiologist was summoned immediately. Dr. Steve Samuel spoke calmly and moved swiftly as he completed my exam. I had blood work done, an EKG and some other tests. I remember feeling extremely anxious and fearing for my life.” Marie had a cardiac catheterization with dye studies so that the doctors could view her coronary arteries. The X-rays revealed two severe blockages that were causing her angina (chest pain) episodes. Later that same day, Dr. Samuel came by to discuss her test results. Most fortunate for Marie was the fact that she did not sustain a heart attack, but, in order to prevent one from happening and improve the blood flow to her heart muscle, the surgical team recommended heart bypass surgery.
“My first thought was to go to another hospital for the operation, but then, my brother, Tony, came in to see me and told me that the hospital I was in was the best hospital for open-heart bypass surgery. He said that he knew this because the state report cards on open-heart surgery are public information in our state. He said the report indicated that the surgeon had operated on more than 200 people last year and that he had no fatalities. That was quite remarkable...not one person died under his care. We also found out that many of his patients were women. I began to realize that my brother was right. I decided to place my confidence in this hospital and the surgeon. I told my brother that I would agree to meet with the surgeon, so long as Tony stayed by my side. He agreed to remain with me for the entire time that I was in the hospital. I can't tell you how good that made me feel. I knew then that I would survive.
“That same night, I met the heart surgeon, Dr. Glenn Laub. He seemed very confident. He answered all my questions and explained everything to me. He drew me a picture of my heart and showed me where the blockages were. He explained how he would operate and told me that the surgery would be scheduled the next day. I felt good after meeting him. I felt like everything was going to be O.K.
“The next day, I had the operation as scheduled and everything really was O.K. The nurses could not believe how quickly I recovered. I was up and about -- walking around in my room -- just a short while after the surgery. Of course, I am very young and I don't have arthritis or anything so I knew I would do well.
“It's been about 6 months now that I had the surgery and you can barely see my chest scar. The surgeon did an excellent job with invisible stitches under the skin.
“I realize I had several major risk factors for heart disease. Family history, overweight by about 15 pounds and no regular exercise. I am also post-menopausal as I had a hysterectomy 7 years ago. My biggest risk factor, however, was cigarette smoking.
“I have a new appreciation for life. I lost 10 pounds and have 5 more to go. I walk for 20 minutes every day during my lunch break and I quit smoking. It was so hard to quit. Incidentally, I no longer have upper abdominal pain so this must have been a warning sign of heart disease.
“As far as stress is concerned, I try to practice relaxation exercises, but it is difficult. I made a commitment to myself and to my children, though, to live a healthier life. Thanks to my cardiologist, my heart surgeon, the nurses, and my family, I have a second chance.” - bha
This story is based on an actual episode of one woman's experience with heart disease. Family members' names were changed to protect privacy. Dr. Steven A. Samuel and Dr. Glenn Laub are affiliated with St. Francis Medical Center in Trenton, NJ
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