Webster’s defines “time” as the measured or measurable period during which an action, process, or condition exists or continues: duration.
Some of us may experience irritation when we have to wait at another inconvenient red light, or in line at the grocery store behind someone writing a check because our time is so important. However, what if the time at hand could mean the difference between life and possibly death? How important is time now?
Jim Knauf knows the answer and sees and treasures “time” in a whole new light after recently experiencing a heart attack and being fortunate enough to be a patient of a very good cardiologist, Dr. Anjan Gupta of UH Harrington Heart & Vascular Institute and Director, UH Portage Medical Center Cath Lab.
Earlier this year Jim and his wife were having a very positive meeting with their financial advisor, discussing and planning for the future. Unexpectedly and very painfully, that future came into question as Jim began experiencing excruciating chest pains, which would later be determined as a severe heart attack.
“I experienced chest pain like I had never had before,” said Knauf. “The pressure across the entire chest was overwhelming, and I had trouble breathing and gasped for breath.” He continued, “My vision blurred and I couldn’t find a bodily position to get relief.”
EMS was called and in less than 20 minutes, they arrived at the Emergency Department at UH Portage Medical Center. As the doors of the ambulance opened, there stood Dr. Gupta.
“We have an integrated system for heart attack care at UH Portage where we work very closely with the local EMS in Portage County,” said Dr. Gupta. “They can electronically send us the EKG of the patient from their actual location, and if the ER physician confirms a heart attack is taking place, we mobilize the cath lab team and take the patient straight to the cath lab from the ambulance.”
That’s exactly what happened. Within minutes Jim found himself in the cardiac catheterization lab where a group of medical staff immediately took over prepping and sedated him with just enough anesthesia to ease the discomfort, allowing him to stay awake through the procedure. “I found it interesting that in doing the prep, they not only prepared the left side of the groin, but also the right side and the arm; as back-up locations for the cath, should such be necessary,” said Knauf. “Of more interest was that the entire procedure was performed utilizing a piece of medical equipment called a C-ARM (a medical imaging device, based on x-ray technology), which allowed the staff to observe through a series of monitors, the passage of the catheter through the veins and into the heart, indicating both healthy arteries, as well as any blockages.”
In Jim’s case what was found was a 100 percent blockage of one artery and two additional blockages at 85 percent. Dr. Gupta chose to immediately address the 100 percent blockage and put in a stent. The remaining blockages were taken care of a few days later. According to Dr. Gupta, “In the cath lab, the team works in a very coordinated way to get the patient ready for the cath, and we open up the artery that’s causing the heart attack as fast as possible to save the heart muscle.” Here’s where the importance of time comes into play (again).
In Jim’s case, Dr. Gupta and the cath team were in the process of making health care history. The American Heart Association recommends a “door-to-balloon time” (D2B) of no more than 90 minutes. At UH Portage the average time between when you arrive at the hospital and when your blockage is opened is 40 to 50 minutes. Prior to this particular instance, the shortest time Dr. Gupta achieved was 11 minutes.
“Now hear this! In working on me, Dr. Gupta and his team completed the insertion within a record breaking (setting) nine minutes,” said Jim. He added, “Timing is everything when you are in the hands of an excellent cardiac team.”
For those that like statistics, the survival rate for those who experience a STEMI (ST-Elevation Myocardial Infarction), which is a severe heart attack during which one of the heart’s major arteries is blocked, is only six percent, when such an event occurs a long distance away from adequately equipped and staffed cardiac care unit. “With a blockage of 100 percent of the left anterior descending artery, the procedure that Dr. Gupta performed on me saved my life,” said a grateful Knauf.
Jim was told later by Dr. Gupta that he was in the midst of a heart attack during the stent insertion. Following the completion of the procedure he was transferred to the Cardiac Intensive Care and Step Down Unit to recover for a few days before two more stents were implanted to address the remaining two blockages. “Within 24 hours I began doing laps around the nursing floor, all surrounded by wonderful, attentive caregivers,” said Jim. After another successful procedure and time mending back in the Cardiac Intensive Care Unit, the mid-Friday morning nurse said three words Jim may not have heard had it not been for Dr. Gupta and his team, “you’re going home!”
Dr. Gupta gave Jim his discharge orders, scheduled a follow-up appointment and encouraged him to take advantage of cardiac-rehab services. “The following Friday, I had my follow-up with Dr. Gupta where he shared with me great news – no heart muscle damage had been done,” said Jim. “I was cleared to begin assuming more normal life practices. I couldn’t be more grateful to have been in the hands of an excellent cardiac team.”
Following a later rehab session, Jim ran into Dr. Gupta in the hallway and told him that during a recent visit with his nephrologist and reviewing his EKG, the physician said that he would not have known that Jim had recently experienced a severe heart attack, as no heart muscle was observed – an affirmation of what Dr. Gupta had said earlier. “Dr. Gupta then commented, ‘timing is critical’ and he couldn’t be more right,” said Jim. “Unfortunately too many people don’t listen to their symptoms, believing that they’ll pass or just flat out deny they’re even having a heart attack.”
Not all stories as they relate to heart attacks end as positive as Jim’s. Did you know that 1 in 9 men will experience sudden cardiac death, most before age 70? Women aren’t discriminated against when it comes to heart attacks either. Approximately 1 in 30 women also have a higher lifetime risk of early death due to sudden cardiac death.
“Studies have shown early intervention leads to better outcomes in heart attack patients and decreases long term mortality and morbidity,” said Dr. Gupta. It’s better to error on the side of caution, than to wait and experience unnecessary heart muscle damage – or worse.
Jim summed it up by saying, “As I understand it, Dr. Gupta performs on average six to eight caths a day. If you’re as fortunate as I was, he may be waiting for you at the door.”
Time was extremely important from the moment Jim experienced his chest pains, calling EMS and the arrival to UH Portage Medical’s Emergency Department where Dr. Gupta and his talented team were waiting. Because of the medical innovations available here locally and the expertise of Dr. Gupta and a crucial nine-minute procedure, Jim has what so many take for granted…TIME!