Arriving early for my stress test in June 2019, scheduled due to a bad EKG the day before, I sat in the waiting area intent on relaxing. I did some light meditation around acceptance until the tech called me in. Based on the EKG results and various symtoms during the months before, I knew something was amiss with my heart. The tipping point was the easy hike in Hawaii that felt like a 50-lb. monkey was sitting on my chest.
This was not my first rodeo, as they say. With my first stress test 4-5 years before, I knew the drill and how “fun” these could be as they wind up your heart rate while on a treadmill cruelly involving varying speeds and slopes. Back then it felt like the objective was to make me pass out, but in reality only to work my heart rate up to a specific target for a period of time. The theory behind the test is with a dye injected into your veins, then the CAT scan images before/after the stressing, they can see your good (or bad) “pipes.“
Despite wishing I wasn’t there, I was grateful how things had aligned and uncovered the issue through my long-time OD physician during a visit to my former Ohio hometown.
This time the approach was to get this 60-something’s heart rate up around 140 for about a minute. Sounds easy, but since I wasn’t feeling well, I had concerns whether the stress test would uncover the issue or kill me quickly.
Surprisingly, no doubt because I’d been hiking a lot in the preceding six months, I made it to the target point and held for the required time. Despite my legs feeling like rubber, my head light from the exertion, and my lungs working overtime, I finished. One of the two test nurses then helped me onto the gurney bed beside the treadmill. There I’d relax and recover until my blood pressure (BP) returned to pre-test levels. After that, they’d wheel me over to take CAT scan for my “after” glam shots
T-Minus 10 Minutes
The expected BP recovery back to normal after a stress test is about 5-8 minutes. But, after 10 minutes, mine had not dropped: it remained high as when I finished the test. This abnormal reaction caused a third nurse to come in and consult on how best to get my numbers down so the scan could proceed.
I chatted freely with the nurses and felt reasonably okay, but my BP was still stuck like a high-revved engine.
“Let’s give him five more minutes and that should do it,” said the new nurse after checking me out.
T-Minus 5 Minutes
Still no BP change, and now a fourth, and seemingly more experienced nurse, entered the room to join the team.
“Let’s give him some water and have him sit up a bit and see if that helps.”
T-Minus 2 Minutes.
Still. No. Change.
Now the nurses paged a cardiologist to examine me. He arrives quickly, notching up the expertise in the room and making me feel they’re taking good care of me. After a bit, he orders a nitroglycerin tablet and I take it.
T-Minus 1 Minute, 30 seconds
Within a blink of swallowing the pill, a wave of unusual feelings rush through every part of my body as the nitro dilates seemingly every vein in my body. Suddenly, I have blood and oxygen circulating like I was twenty again, and it was marvelous. Nothing hurt and all senses were now on 11. I felt like I could have run a marathon at that point. Apparently, my body was digging this new feeling like it was cocaine (ahem…or so I’ve heard). Pleased with the quick results, the nurses noted my declining BP as it approached pre-test levels.
Right about then, I turned ashen, and began to sweat profusely out of seemingly ever pore in my body. I barely had time to utter “I feel really weird” when it seemed like someone turned out the lights.
T-Minus 1 Minute
Time now seemed sped up.
My BP dropped below normal and kept falling until the monitor ]no longer read it.
I’m unable to respond to the nurses.
I’m unable to move any part of my body.
I can’t open my eyes to see.
But I can breathe. And I can hear everyone in the room.
Now there are two cardiologists and four nurses in the room working feverishly to stop the BP drop. As my breathing begins to slow, I hear the experienced nurse who‘d been trying to find my BP with her learned fingers and ears using the old-school cuff-and-bulb, scream out, “I have BP! 38 over 52.”
I vaguely remember hands quickly fussing with my IV port, later learning they’d injected a drug followed by some solution on full flow.
Finally, my breathing normalized and I slowly become aware of my body and could move my hands a bit. My eyes finally open and see 6 pairs of eyes staring at me intently from serious-looking faces.
Quick Recovery and The Fix
In a matter of minutes I seem back to normal and chatting with the team. After giving me another five minutes to be sure no further crash occurs, they wheel me in for the post-test scan, revealing a serious blockage in my widow-maker artery, leading to a subsequent successful stent insertion.
I was fully awake during the surgeons stent work and found it fascinating and awed by the technology and skill of the procedure. Quite amazing how he managed to thread that tiny metal tube with inflation balloon up through the chaotic venal network to the right spot to inflate the stent and the blockage.
While recovering from the procedure in my overnight room, one of the stress lab nurses stopped by, and we chatted about the event. At this point, I hadn’t had any feedback on what happened, and even while it was happening I was thinking I must have fainted or became too light-headed from the stress test.
She shared how concerned and worried they were when I wasn’t recovering or responding, and when I went into cardiac shock from the too-rapid opening of the veins and subsequent BP plummet, they went into emergency response mode. And while she obviously couldn’t come out and say it, after some clues and query, it seemed they had less than a minute to bring me back before a flatline.
My telling of the event comes from remembrance and this post-procedure conversation with the nurse. Until then, I had no idea it was a rare event. They always tell you before these kinds of things about the small chances of this or that going wrong, but who ever believes it could happen to them?
I pondered on all that had happened while in that hospital room overnight (not a lot else to do but think). I remember being calm during the event, and not panicked thinking “this is it.” I seemed fascinated with observing the experience and listening to the team work. Clearly I was at ease and trusting they would take care of me.
Weeks later I got confirmation from a neurologist friend on how close I was. I shared the events and remarked how odd I thought it was that only my breathing and hearing seemed to define me as I lay there on that gurney. She responded that those are the last two functions we have before we’re gone.
They say that some people know when it’s their time to go before they pass. I guess on that day it wasn’t my time because I didn’t see any bright lights nor that odd dude dressed in black carrying a scythe. I seemed to float through the experience and come out of it and back to the real world.