What happened to my dad??

A couple weeks ago, on Tuesday, January 26th at 9:00am, I got a call from my step mom. It was a call that I have always feared...my dad had a heart attack and was being taken from his tiny hospital in Twentynine Palms to the large hospital in Palm Springs. By ambulance...

It was such a horrible phone call. I was at work and started crying uncontrollably. Paul had to come get me and we ran straight to Palm Springs. It was a nightmare. Below is the email that I put together for my stepmom, we were comparing notes afterwards to find out what went wrong.

Tuesday

In the ER, the nurse, Jessica, told us that Dad would be sent to the ICU while he waited for his cath, since he was on Nitro and he had to be in the ER or ICU on a Nitro drip. After a few hours, Jessica told us that she was trying to get him into the cath lab, but that they couldn't take him until 5:00 pm so she was going to send him to telemetry until then. I think that is when his Nitro drip was stopped.

Dad was moved to Telemetry and they came to get him for the cath around 4:45pm. Around 5:30pm, Dr. Rao came into the cath lab waiting room and told us that Dad had several major vessels that were 70%-90% blocked and that his right coronary artery was 99% blocked. Since he had so many vessel involved, Dr. Rao said that Dad needed a triple bypass in the morning. Sean, the cath lab manager, walked back to telemetry with us and said that Dad would see Dr. Habibipour between 8:00 am and 9:00 am to discuss the surgery and since they had a light schedule he would probably be operated on wednesday morning or afternoon at the latest, that Dr. Habibipour does 2 bypass surgeries a day.

Wednesday

Morning came and went, I got there around 10:00 am and no one had been in to talk about anything. At 10:30 am we started asking the nurses to page Dr. Rao and Dr. Habibipour to find out what was going on. A case manager was on the floor and called the Operating Room and told us that the OR said that dad was tentatively on the schedule for thursday. He was still NPO at this time.

At 12:00 noon, after 3 pages for Dr. Habibipour and 2 for Dr. Rao, Dr. Rao came in and didn't tell us anything. He said that Dad needed surgery and that it was up to Dr. Habibipour when he would have it, but that he thought it would be thursday and that Dr. Habibipour would be in shortly to talk to us. I asked Dr. Rao if dad needed to be back on Nitro until the surgery and Dr. Rao did not answer me. I asked Dr. Rao if Dad could eat, since he wasn't having surgery. He said that he had tole the nurses at 11:00 am that he could eat. Dad still had the NOP sign on his door and Dr. Rao took it down.

5 minutes later Dr. Habibipour came in and explained bypass and all the risks. He said that he was going to operate at 7:00 am on Thursday morning. I asked if Dad should be back on Nitro until surgery and Dr. Habibipour said that was up to Dr. Rao.

The day passed uneventfully, I asked the nurse, Maria, if Dad should be back on Nitro and she asked if he was having any chest pain. He wasn't, so she said no.

I left the hospital around 6:30 to find a hotel and get some toiletries. I called Dad at 7:30pm to tell him where I was and say good night. He told me that he was having chest pain and that they were going to take him up to the ICU. After talking to him, I called the nurses station back to get their version of what was going on, figuring Dad didn't want to worry me. I spoke to his night nurse, Tristan, who told me that they were taking Dad up to ICU. I asked Tristan if that was normal right before someone had bypass surgery and he told me that he was new and didn't really know. I hung up.

5 minutes later, Maria (Dad's day nurse) called me and said that Dad was having chest pains and that they had to take him back into the cath lab right away because the nitro pills weren't working and that after that he'd be int he Cardiac ICU. She said that I might want to come back.
I arrived back at the hospital at 8:10pm and Dad was being wheeled into the cath lab. He had the portable EKG machine onhis bed and he was in Vtach the whole way. I asked Maria if this was normal and she said not really, that his EKGs had been all over the place the last couple hours.

Dr. Himelman came in and introduced himself to me, and said that Dr. Rao was out of town so he was going to do the cath. He told me that understood that Dad was scheduled to have bypass in the morning and he was going to try to open the blocked vessel with the balloon, but if he couldn't, he would have to stent and Dad couldn't have bypass for a couple months.
8:30pm they took Dad into the cath lab. At 9:45pm Dr. Himelman came out and said that he had to put 4 stents in to open the vessel and gave me a picture of the before and after. He told me that because of that it would be at least 4 months before Dad could have bypass.

I asked him if he would answer a couple of questions. He said that he would rather not. I asked him if this all could have been prevented if they had kept Dad on Nitro all day. He said that he didn't want to answer that. I asked if he felt that they should have done the bypass that day. He said that he was uncomfortable answering my questions, and that Dad wasn't his patient, that I needed to talk to Dr. Rao. He started to walk out of the room and I followed him and asked him who I should talk to if I felt that Dr. Rao wasn't acting in my Dad's best interests. He said that he didn't want to answer that and walked away.

10 minutes later they let me go into the cath lab to see Dad. I told one of the nurses that I felt that this was Dr. Rao's fault for not acting quickly enough and not keeping Dad on Nitro. She told me that Dad might have died on the table if they had tried to bypass that day. I might have told her to shut up...I wasn't really in a very good place at this point.

We got up to the Cardiac ICU around 11:00pm and the nurses got Dad settled quickly. Noticing that I was quite upset, they calmed me down and told me that things happen for a reason, that maybe bypass wouldn't have been a good thing, if Dad's heart was too weak. One of the nurses said that sometimes they will wait 2 days after a heart attack to do bypass to see if the heart can handle it. They got Dad comfortable and I went back to the hotel to get some sleep.

Thursday I got the hospital at 8:00am, just as Dr. Habibpour was walking in to see Dad. He asked what had happened, and said that no one had cancelled the surgery and he had a team up from San Diego. He was unhappy about the miscommunication. He said that because of the stents, Dad had to be on Plavix and he couldn't operate while he was on it. He said that it would be 4-6 months before he could have a bypass. I asked if Dad's other vessels would make it that long and he said I had to ask Dr. Rao. I asked if he felt that the stents would cause any problems with the bypass in the future and he said no.

I wasn't in the room when Dr. Rao came in.

Saturday

Dr. Scott, Dr. Rao's assistant, came in to discharge Dad. He gave all the prescription and aftercare instructions and said that Dad would be on Plavix for a year, that he had to in order to keep the stents open.

Wednesday night, when I was alone in the Cath Lab waiting room, was the lowest moment of my life. I thought my dad was going to die and I was there all by myself. If it wasn't for my friends who were texting me the whole time, I think I would have lost my mind.

Here we are. almost 3 weeks later and Dad is doing well. I had lunch with him this weekend and he looks good. He went home after they released him and started following the instructions for a healthy diet and exercise program. He has lost 14 pounds already and is hoping to get his arteries in such good shape that they don't have to do bypass.

When we were at lunch, he got a call from case manager at the hospital. They are doing a "risk management review" of his case because we are still questioning why he had the second heart attack. Hopefully we will find out that they did everything they could and there is no premanent damage to him.