Saturday, January 6th, 2013

My amazing recovery was remarkably quick. By Wednesday evening I was alert, my catheters removed and I was prepared to be moved to Step Down. Pakesh was called off for the evening.

Dr. Sullivan and I had a conversation that went something like this:

Dr. Sullivan: “Many patients in your position are served well by a smoking cessation program. I like to see you start something before you leave the hospital, and I can order you patches or pills right now to get you off to a good start.”


Me: “No thanks, I don’t need it.”

Dr. Sullivan: “Everyone can use something - are you sure you don’t need something?”


Me: “Actually yes. I need the EKC that caused those guys to run out of the ER and ask for LifeFlight.”

I was moved to Step down and met another wonderful caregiver, who managed to calm my impatience over the next 48 hours. God, I wanted to go home. Pakesh stopped by both Friday and Saturday to check on my progress. We had a great conversation about God and spirituality on Friday. I told him he saved my life. He refused to accept that, instead giving God the glory and he was "merely there as a servant of Him." Though he is a Mystic and I a Christian, he was comfortable talking in terms of a Christian God and I know Pakesh was sent to save my life. I thanked him, promising to send a letter on his behalf to the hospital. He wants to be a Doctor or a Nurse, but he doesn't have the finances to make it happen. I pray God finds a way for him.

Standing in the way of going home were hospital procedures, a concerned wife and the practical implications of my condition. Dr. Foster-Smith had ordered a Zoll LifeVest for me, a nifty device that will likely keep you alive in the event you suffer an additional heart failure when you are unattended. In the “old days” patients like me would have likely been ordered into a nursing home or other long care facility for 30-60 days.

The LifeVest is a wearable defibrillator is worn by patients at risk for sudden cardiac arrest (SCA). Personally, I hated the thing. It was tight and uncomfortable and included a 15 lb defibrillator / battery attachment that was designed to first warn you with a series of vibrations and beeps, then, if you failed to respond, shock you with up to 3 events. You’re never supposed to let it happen - it’s only supposed to go off if you can’t resound yourself. But the think is filled with Gel packs and other stuff to keep you from burning your flesh off, and frankly, it scared the hell out of me. One night after we got home the alerts kept going off and Michelle and I spent the night sleeplessly deciding if we should turn it off or go to the ER. (We turned it off after the third call to tech support).

Anyway, a lot of things had to go right for me to go home, and I wanted to share a couple specific ones. First, my discharge required a whole lot of people to sign off, and without Cassie Kube (my nurse) I would have gone crazy waiting. She was awesome. Despite my rapid recovery and incredible story, I was still a bit of a hot mess. I was pretty sweaty yucky, and I was begging to take a shower. The LifeVest is a real mother to get on and off, and I was basically told don’t take it off at all. So Michelle wasn’t going to be real big on bringing me home and me taking it off first thing. So after a few ignored requests and Cassie doing everything she could to find someone to sign off on a shower, she relented and said “A happy wife for a happy life, right?” So that was great. She helped me in the shower and I felt really great just getting all cleaned up, shaved, etc. I put on a Twins shirt (over my LifeVest) and a pair of jeans. I grabbed my Kindle, sat on the chair, and waited for the slew of final visits from Occupational Therapy, Cardiology and someone referred to as “The Hospitalist” which I had never heard of before. It's their job to go over your records, review your condition and make the final yes/no about going home.

Dr. Gossel was a very pleasant and attractive woman who arrived just moments after I settled into the chair. She introduced herself as "The Hospitalist" and asked me if "...the patient was at Rehab?" I told her I was the patient.

Dr. Gossel: "Wait, you're the patient?"
Me: "Yes."
Dr. Gossel: "That seems unlikely."
Me: "Why would you say that?"
Dr. Gossel: "You don't appear to be the guy I just spent 30 minutes reading about."

We chatted for 15 minutes. I told her about my time in the ICU. I told her about the miracle. I told her about Pakesh. She was wrapped up in the story. I cried when talking about Pakesh and she started to cry with me. "Nobody can under estimate the power of believing and faith" she said.

While we talked, the staffing cardiologist walked in and together they reviewed my case. "His story is a miracle - nothing short" she told the cardiologist. He seemed unimpressed. "I would have bet every dime I had that there's no way he could be going home today if you just read the charts" she told him. "Once in a while a patient can surprise you" he replied.

God is the key to surprises. He is the one who heals, who authors the miracles we see around us each day. Regardless of the medicine, it is Him who can overcome the adversity that those who clinically analyze the situation will say can't be overcome. I am one of those stories - those tales that defy the logic.

Postscript-

The year of recovery has had ups and downs. As I recall these memories, I can't help but thank God for His great healing and the believing faith of those around me. I am where I am today because of God's promises, but I also believe the changes to my health and my continued improvement are the result of smart eating, great supplements and physical exercise. I have been surrounded by great friends and wonderful family who have been so supportive and helpful.

Mostly, I owe my wife, Michelle, all the kudos one can reap upon another human. She loves me beyond measure and drives me crazy with her concern. I can't imagine being this healthy without her, and while I love her unconditionally, I also feel a deep debt of gratitude because she has been there "for better or worse . . . in sickness and in health."

Who can find a virtuous woman? for her price is far above rubies. (Proverbs 31:10)

I found one.

Wednesday, January 3rd, 2013

His name was Pakesh, and I first "met" him on Monday but he had been watching over me intermittently since Saturday night. He's an ICU orderly, but they call him a babysitter. I had other babysitters in ICU, but Pakesh was noticeably different. While the others were attentive, the first thing they did was change the TV to whatever they wanted to watch and that's how they spent the time in my room. Pakesh was a reader and a thinker. He wrote letters home. Babysitters are not "medically" trained, although I'd be happy to have Pakesh around in an emergency; he knew a lot. Rather his job is to sit with the patient so the nurse doesn't have to be there all the time. If anything goes wrong, he's the human alarm. If anything else is needed, he does it. He was sent by God to save my life, and this is our story.

I was a hot mess. I don't know how often I pooped myself, but every time I was alert for a few seconds I felt like I did or was or was about to do so. Pakesh was so gentle and tender and understanding. He would roll me over, take care of things and tell me it was ok. I'd be so apologetic, but mostly I felt deeply depressed at these times. I was barely alert and in distress, and I know I believed this was my life from now on. I wasn't able to put together thoughts of recovery - I could only see the dread. Pakesh would speak softly to me. I'd apologize and cry and he'd tell me "It's all right - that's why I am here. You will be ok and I will take care of you until you are better."

Pakesh had taken a special interest in me. He had seen my wife and family read The Word and pray for me. I heard him on the phone agreeing to an extra shift "if I can watch Mr. Carter." He was the most constant companion I recalled during these days - even though my wife and brother were there more often, Pakesh was my care giver and my lifeline to conscious thought.

God gave me plenty of warnings about my health, most of which I ignored. You can't blame God for telling you to avoid the accident and determining to drive yourself into the wall anyway. I have experienced it so many times, and if you think back I'd be surprised if you haven't as well. A still small voice; a thought as clear as if it were written on a wall; a cleared field to run through in the midst of chaos. I don't know how God speaks to you, but these are some of the many ways He has spoken to me. God never wanted me to have a heart attack - but God wanted me to be delivered. And while I didn't heed the warnings, God never gave up and He sent Pakesh to comfort me and help me hear His clarion call.

At 4:00am Wednesday morning, my brother (who is an ordained clergyman) awoke in the basement of our house and describes himself as "discomfited" with God. He never feels that way. He began to pray. Within a few moments, he said he felt a palpable presence of God and he knew everything was going to be Ok. "I got this" God told him. The wheels were set in motion with my brothers prayer and believing. God isn't always early, but He is never late. The miracle was happening and it started in the basement of our modest Eagan home.

At 4:15am, I awoke. I was incredibly alert and in terrible, agonizing pain. I had gained over 40 pounds since I arrived in the ER. I was taking enough Lasix to drain Lake Minnetonka. The added weight, the amount of work it took to breath, the severe angina (which they could not relieve with Nitro because I was reacting terribly to its administration) and the incredible depression had won the battle, and I was ready to surrender the war. I rolled slightly (I was still securely restrained to the bed) and saw Pakesh. He was sitting in a chair 2 feet from my bed. He had been meditating. With my eyes barely open, I called out.

Me: "Please help me. Please. I can't take this anymore."
Pakesh: "It's Ok. What can I do.?"
Me: "I'm so sorry, I have soiled myself again. I hate this. I can't go on."
Pakesh: "Don't worry, Mr. Carter, I will clean you up. It's Ok. I will take care of you."
Me: "I can't do this anymore. I hurt so much. I want to quit. All I have to do is close my eyes for 5 minutes, and it will all be over."

I had felt this for a couple days. All I had to do was decide to close my eyes for 5 minutes . . . 5 more minutes of pain and the comfort would come. I believed this without any doubt. Death was completely in my hands and it had won. I was ready, willingly, to embrace an end. I believe in Eternity, I know God has far greater things in store for me than this earthly life. Imagine that! While my life has had its struggles I have joy beyond joy and love everything I enjoy everyday. I could write ad neauseum about my addiction and the calamity that once was my existence, but I still wouldn't trade a day for the joy I have today.

Hebrews 12:2: "And let us gaze at Jesus, who is The Author and The Perfecter of our faith, who for the joy that was his, endured the cross and ignored the shame, and he sits upon the right side of the throne of God"

Pakesh came and sat on the edge of my bed, and gently began to caress my shoulder. In his deep Tibetan accent, that delightful dialect that sounds calming and joyous and spiritual to me:

"Oh, no, Jeff, you cannot quit. You must stay strong - you have so much to live for. Look at your family, how they love you. Your wife, your brother, they have been here and praying for you. Think of your tender son - he still needs his father. And your grandson! You have not yet met him. He needs you.

God is not done with you, Jeff. You mustn't quit."

These words fell on my ears like tender drops of rain on the garden. My soul was thirsty for the sustenance; my heart ached to believe. Pakesh continued to massage my shoulders and wiped my forehead. I wept in his arms and reached for his hand. He got off my bed and kneeled at my side. Looking deeply at me, his warm, compassionate eyes locked onto mine and he made a fervent plea:

"Do not give up yet. I know you are tired and hurting. But you must try one more time. God has not come to take you, but to heal you."

With that I felt a warmth throughout my head, heart and body. It was as if I had been dipped in a warm bath, inside and out. My intense pain immediately began to subside. While Pakesh continued to speak, I let the sound of his lyrical incantations drift through my ears, into my head and down to my heart. With each syllable came peaceful relief. Pakesh could feel it as well. While he continued to succor me, a nurse walked in. He looked at her and said "He will get better now." She didn't fully comprehend the meaning, and methodically went about checking my vitals while Pakesh continued to hold my hands and speak.

"When she is done, I am going to clean you up. You will feel much better. I will take care of you, Jeff. You will be all better soon."

When the nurse finished, Pakesh spent 30 minutes cleaning me up. I got a bed bath, clean sheets and a non-stop barrage of joyful musings from his spiritual center. I don't know what he was saying - I was coming down off my cloud and peacefully waiting to land. Every sponge stroke, every careful touch, I felt God calming me, relieving me through Pakesh's fingertips. By 5:00am I sunk into a deep sleep, and for the first time since arrival, did not awaken for 4 hours.

Around 90 minutes later, my brother walked into the ICU and saw Dr. Foster-Smith, another cardiologist who was regularly monitoring my case. He was standing at the desk, and my brother asked him if he had seen me. "Your brother has made a miraculous recovery."

Yes, I had.

Tuesday, January 2nd, 2013

It was alarming to me to read the recap of my stay at Fairview Southdale. For four days, I recall only moments - some of which I am not too proud of - of my recovery from the procedures. There were 19 physicians and 11 nurses who signed off on notes and procedures during my stay. I remember 3 physicians and 2 nurses, and an incredibly special employee who was sent from God to save my life.

From the admission notes:

Mr. Jeffrey Carter is a pleasant 55-year-old-gentleman with a history of smoking and insulin dependent diabetes who was admitted with an anterior STEMI. He underwent emergent coronary angiography and intervention for an occluded left anterior descending artery . . . Given his cardiogenic shock, an intra-aortic balloon pump was placed in the angiographic suite.

It’s a lot of medical terminology that means I was in dire shape and needed some extraordinary measures. “Cardiogenic shock is a largely irreversible condition and as such is more often fatal than not.” My heart was severely damaged, my node irreversibly so, and my paid was listed as 9/10 for the three days after the surgery.

I recall a few events - not all of them accurately - from Sunday and Monday. I don’t remember anything from Saturday post ambulance trip. The Vikings played Green Bay and won 37-34. I swore I watched the movie with my son Adam, but he was on an airplane so that wasn’t possible. My daughter tells me I talked to her, excited about my upcoming trip to Portland to see her and my new grandchild. I don’t recall the conversation, but apparently I was in good form. My brother, Steve, arrived from Chicago on Monday to a tirade I was having about the bathrooms being filthy (of course, I’d never left my bed so I wouldn’t actually know) and I began to believe that people were trying to kill me. I demanded a hospital administrator, an attorney and a judge and begged my wife to move me to another facility.

Michelle: “Jeff, you are in good care here. Don’t you trust me?”

Me: “No, I don’t trust you.”

Michelle: “Your brothers here, he agrees with me, do you trust him?”

Me: “Barely.”

Ativan and morphine are a powerful combination. My wife assured the staff that I was a really easy going guy, and this wasn’t me talking. The only time I would calm down would be when Michelle or Steve came into the room and read The Bible to me. Otherwise, I tended to get very agitated and difficult to control. I was tied to the bed, since I had so many catheter lines and the intra-aortic balloon pump still helping my heart recover.

Tuesday night after Michelle and Steve went home, Dr. Chris Sullivan and I finally had it out. Dr. Sullivan was the ICU chief who oversaw most of my recovery. He’s a Boston Southy, looks like a plumber and talks like a roughneck. My brother Steve loved him - he was plain speaking and very honest about what was happening to me. My stay was complicated by severe pericarditis resulting in acute reparatory failure and pulmonary edema. I was in constant pain. I would get down to a 4/5 on the pain scale and be able to have some cognizance for 10-15 minutes. During this time I would try and make sense of what was around - and how I was doing. Between all the drugs I was on I had no bladder control. Whenever I awakened I would often try and fight the restraints. I recall being restrained by the nurse and the “babysitter” in ICU. I frequently soiled myself and during these moments of consciousness I’d feel remorse and sorrow - I would apologize profusely to the staff and I felt a deep depression overcoming me.

On Tuesday evening, I awoke around 9:00 to find Dr. Sullivan in the room doing a review with the nurse. He asked how I felt and I recall telling him I wanted this all to end. He asked me why and I responded that the pain was so intense I believed that they were trying to kill me.

Dr. Sullivan: “Why do you think we’re trying to kill you?”
Me: “Because I am in incredible pain.”
Dr. Sullivan: “We aren’t trying to kill you, we’re trying to help you.”
Me: “But I’m in agony here.”
Dr. Sullivan: “Because we need to keep your heart beating - we can’t put you out much more, because you need a chance to heal.”
Me: “Then why does it hurt so fucking much!”
Dr. Sullivan: “Why? Because you’re not supposed to be here, fella. You’re supposed to be dead. Nobody makes it through this. So buck up and deal with it.”

Epiphany 1, Jeff 0.

I wasn’t awake much longer - the nurse administered more sedatives and I fell off the edge again. But I remember those words so clearly, because it was the first time I actually realized how sick I was, and how close I had been or seemingly was to death. I was ready to quit and as I passed out, I prayed for final relief from all the pain.