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Healing From a Heart Attack

Sandy O?Donnell

UnitedHealthcare member Sandy O'Donnell is usually the last to leave a party. So when she felt so tired that she needed to leave her softball team's festivities early one July night in 2005, she blamed it on heat exhaustion. What happened next was beyond unexpected.

Not feeling quite right

That morning, 42-year-old Sandy woke up feeling as though something was stuck in her chest. Assuming this discomfort was due to something she ate, the New Jersey native headed to work as usual. Typically an upbeat person, the fatigue she also felt was out of the ordinary. But, she'd been working long hours and dealing with the stress of renovating her condo.

To her dismay, the strange sensation in her chest stayed with her all day. When a friend picked her up after work for their softball game, Sandy described how she'd been feeling, as if she needed to burp. Her friend suggested drinking water, but that didn't seem to help. Still, Sandy shrugged it off. After all, they were about to play the championship game – a game they would go on to win.

It was only after the game when they went out to celebrate that she started thinking about the feeling in her chest again. Wondering if it was perhaps an air pocket or indigestion, someone suggested she drink ginger ale. But, the carbonation only seemed to make the lump feel even bigger.

At that point, she asked her friend to drive her home. When they got outside, however, Sandy vomited. Despite her protests, family and friends insisted she go to the emergency room, so her friend drove her to Bayonne Medical Center.

The shocking diagnosis

Blood work and an exam at the hospital established that Sandy had had a heart attack. Can you imagine playing the championship softball game in the heat of July while you're unknowingly having a heart attack? Sandy was lucky she hadn't collapsed right there on the field. The news, of course, devastated and frightened her. Although working at a stressful job, admittedly overweight and a smoker, she was young, played softball all her life, hiked, biked and was active all around. How could this happen?

The doctors immediately admitted her to the Cardiac Care Unit and gave her a nitroglycerin patch, typically used to help ease chest pain. Within 30 seconds, she felt a massive headache come on and went into cardiac arrest. They shocked her back to life and rushed her to Saint Barnabas hospital, which has specialized facilities to manage this type of situation.

At Saint Barnabas, doctors inserted two stents in her arteries – wire metal mesh tubes used to hold arteries open if they become blocked. Her recovery was quick and her doctor planned to have her come in for a second surgery to implant two additional stents. In the meantime, she was in a "waiting period" until the second surgery, giving her time to recover and prepare for the next surgery. Doctors didn't think her situation was extremely urgent, and she was able to continue life as before.

Sandy is not one to slow down. Despite her heart attack, she was determined to go on her planned vacation to Ireland in August. It was a trip she dreamed of her entire life. She would be going with her aunt, who was age 70 at the time, so she didn't want to delay. Pleased with her recovery, the doctor let her go on the trip, on the condition that she would come back in September for the second surgery. Even though she knew her health journey wasn't over, Sandy relaxed with her doctor's OK, and figured things weren't too bad.

A second surgery

After her trip, and feeling well, Sandy arrived at the hospital for the second set of stents. But, her planned surgery took an unexpected twist. While on the operating table, she had another heart attack and a surgeon performed an emergency double bypass.

"When I woke up I was on a respirator. I was devastated," Sandy said. Her usually calm demeanor gave way to tears. Thinking about her mother – who'd had a double bypass in the very same hospital, but died at age 51 of a massive heart attack – overwhelmed her even more.

Sandy had never expected to have a double bypass at such a young age herself. The emergency surgery was certainly unexpected for her doctor, too – he later told her he hadn't wanted to perform a double bypass on someone so young. He was hoping the stents would be enough. But, without the bypass, there was a possibility she wouldn't have made it.

The recovery from the bypass was, as Sandy described it, "unbelievable." She said her mood was very somber, her body incredibly achy and swollen. OxyContin® and other painkillers helped, but Sandy was still experiencing intense pain. A week and a half later, she was released from the hospital and began rehab, which included physical therapy and follow-up doctor visits. After being on bed rest during recovery, physical therapy helped her get her strength back. Therapy also provided health education – she learned nutrition tips and the importance of lowering salt intake as well as regular cardio workouts. Medications such as Lipitor®, Plavix®, metoprolol and aspirin also were part of her healing process.

Recovery made it difficult for her to do things for herself. As a very independent woman, Sandy found it stressful having to depend on other people for help. But, it was important that she limit herself to non-strenuous activities for a while. For instance, she couldn't lift heavy things or shovel snow.

Sandy was out of work for six months, but her family, friends and co-workers were there for her throughout her recovery. "I'm very fortunate [for their support]," she said. When her doctor cleared her return to work, she jumped right in with both feet – but she tired a lot more quickly than she ever had before. She was happy to be working again, but found the fatigue frustrating.

Making changes, making a difference

Since Sandy was diagnosed with coronary artery disease, every three months she goes back to the cardiologist for blood work. "It doesn't consume me," she said. "You need to conquer your fears." Sandy has lost 37 pounds, continues cardio workouts and has gone back to doing everything as she did before – including playing softball. Best of all, she kicked her smoking habit.

The care Sandy received through UnitedHealthcare's network "was extraordinary," she said. "[The doctor] had excellent bedside manner, but he made you have a taste of reality at the same time." As someone who wasn't used to having health problems and relying on medication, she appreciated her doctor's straight-forward, open manner. At first, she hadn't understood why she'd have to take medicine long-term. "I talked to him and said, 'People have heart attacks and they're on [certain drugs] for one year, and I'm on them for the rest of my life?' He said, 'You had a worst case scenario.'"

UnitedHealthcare also provided ongoing support by assigning a case management nurse to her case. Sandy spoke with the UnitedHealthcare nurse regularly for a year after her heart attacks. They discussed medication, weight, goals and doctor visits. She said it helped to have an objective voice providing tips and information.

As part of the disease management programs available through UnitedHealthcare, nurses can work with patients like Sandy to develop personal care plans, providing tips and answering questions on an ongoing basis. The goal of these programs is to be proactive and help improve a patient's overall quality of life.

Being prepared – knowing the signs

Long after her harrowing medical ordeal, while waiting at the doctor's office, Sandy spotted a pamphlet about women and heart attacks. "It's a little too late [for me]," she thought to herself, "but let me read it." What she discovered is that heart attack symptoms can be more subtle for women. Many attribute these symptoms to other things, such as stress. In sharing her story, Sandy hopes to raise awareness of the signs of a heart attack. "Getting help right away is vital," she said.

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