The following is a detailed description of the events on the morning I had my heart attack. I wrote this as a form of therapy for myself at the suggestion of a number of people and also as a historical record. It took me several months to complete this as it was very hard for me and I would stop often.
I awoke the morning of Saturday the 28th of February,2004 at about 7
0AM. I was feeling perfectly fine although I had been rather exhausted for a few weeks which I attributed to the HRT (Hormone Replacement Therapy) I had been on. I am a Male2Female Transgendered individual and for 6 months I had been taking anti-androgen pills to stop my body from producing testosterone and for 3 months I had been on estrogen therapy. After I awoke and used the bathroom I returned to my bedroom and took my first estrogen tablet and anti-androgen pill of the day and then drank some water. I sat at my desk and signed on to my computer and read and wrote some e-mail and worked on editing some photos that I had taken at my monthly support group meeting the week before. I was feeling perfectly normal at this point. After I had finished that I turned my computer off and since it was still early and I hadn't dressed or showered yet (I was in my pajamas) I decided to lay back on my bed and conduct a little experiment. Since I was on the anti-androgyne pills I had lost most of my sex drive but occassionally I would masturbate not because I wanted or needed to, but simply to see how much function I still had in that area as it was often a subject of conversation on the TG message boards I posted on and I wanted to have the info avaliable to pass on to anyone considering HRT in the future. So I laid back on my bed and had just started, not even obtaining an erection yet, when I suddenly felt very flush and feverish. I had no real pain but felt an odd discomfort in my face,especially the jaw area and my chest. Naturally I stopped what I was doing and laid there a minute realizing I didn't feel like continuing my experiment. By that time I was sweating heavily. I reached up and ran my hand over my face and the water was just dripping off of it and I felt more discomfort in my chest. I got up and went into the bathroom and got a glass of water and drank it quickly then went back in and laid down thinking I was coming down with something..A cold..The flu..I wasn`t sure, but I wasn't thinking heart attack at all. I had always been in excellent health and exercised regularly doing both stretching and aerobic exercises. After I laid there a minute I realized something was wrong with me. I felt really odd. It`s very hard to describe but I felt really nervous and anxious and had the strangest feeling in my chest. I got up and stood there and suddenly the thought entered my head "This is very bad". I started to go downstairs to see if my brother was there and tell him what was going on and as I got halfway down the stairs I saw he was just going out the front door. He turned and saw me coming and gave me a greeting but continued on out. I stood on the steps hoping he would come back in and maybe see what was up as we often do projects together on the weekend but I heard his van start up and he left so I went back to my room. I sat in my chair a minute trying to get a grasp of how I felt and determine if it was indeed as bad as I thought before getting too concerned. By this time I was just consumed with this feeling of impending doom. My sweatiness had gone away but I had lightheadedness, anxiety, discomfort in my chest and now a dull ache in my left arm. I wasn`t short of breath but rather was breathing very shallow. For some reason I thought, "I`m dying". I've never spent a day in a hospital or been seriously ill in my life but something inside told me I was near death. I glanced around my room at all the things I had unfinished and said to myself; "Just let me finish these things and then I`ll die." I stood up and as silly as it sounds the only thing I could think of was that I would die and they would find my room so messy and I would be so ashamed. I grabbed a piece of notebook paper and a marker and hastily wrote a short note: "I`m sorry that my room is so messy. Please tell Nancy (My ex-wife) that I love her. Good-bye" I put it on the table and gathered all the money I had hidden in my room various places (Long story) and placed it on the table with the note so my family could find it.
I went downstairs and walked into the kitchen where my mother was reading the paper and sat across from her. By this point I felt so badly that I was sobbing softly. She asked if I was OK and I told her no that I didn't feel good and that something was really wrong. I was feeling very light headed. I sat there a few seconds more and told her to call Herman (My brother) for me. As she dialed the phone I walked in and laid on the sofa in the living room. After she called Herman she went upstairs and awoke my nephew John who lives with us and told him to get up and come down and help me. (For the record he got up,went into the bathroom awhile then back into his room and by the time he finally arrived downstairs they were taking me out to the ambulance). Mom came back down and walked over to see how I was doing. I was feeling worse and again something in my head told me I couldn't wait for my brother to come home and I told my Mom to call me an ambulance. Looking back on it all later I am amazed that I instinctively knew how bad my situation was. Like I said, I had never spent a day in the hospital in my life and at 46 my worst injury ever had been a sprained ankle and yet for some reason that day I seemed to know I was dying and had very little time.
My brother Herman arrived home shortly and asked me what was wrong and I briefly told him my condition. I was upset by this time and felt I was nearing the end and was crying a little and he told me to try and stay calm so I could tell them all what was wrong with me. (I think laying on the sofa and staying calm is one of the things that fell into place perfectly that morning and saved my life as it kept my heart rate down. If I had started to panic I am sure I`d have gone into cardiac arrest much sooner.) Not long afterwards I could hear the faint sound of a siren in the distance and Herman remarked that it sounded like my ambulance was coming. It got louder and louder and finally I heard it come to a stop outside my home and the ambulance crew came into the living room. By this time I was starting to see everything in a sort of hazy effect. There was an older woman carrying a clipboard..A man with grayish hair and a mustache and a black gentlemen who seemed to be carrying the bigger medical kits. (I learned later that the woman was a Paramedic supervisor and the white gentlemen was a firefighter/paramedic trainee who had been driving the ambulance. The black gentlemen was a Paramedic from a different Medic unit who was with them that day). The woman stood next to my brother and was asking him some questions while the two men got down next to me where I was laying on the sofa and began asking me what was wrong..How I felt..Etc. I described my symptoms to them as best I could because the feeling in my chest was hard to explain. It wasn't really a pain it was more that nervous uncomfortable feeling one gets when they are very upset. I told them I had been sweating a lot but it had stopped. That I felt dizzy. That I had a pain in my left arm. Mostly that I felt anxious and jittery. As they took my vital signs they asked if I was on any medication and I told them I took Spironolactone and Estrofem for transsexualism. The two men took my blood pressure and listened to my heart I believe and may have done some other things but I can`t remember now and finally they said that everything looked OK. I heard my brother comment that I kept rubbing my left arm and the one paramedic said that they would take me in just as a precaution but that they didn't see anything wrong. The woman then asked me about my health insurance and I said I couldn't remember the name of it (Even though I knew it well) and that the card was in my wallet up in my room. She said that was OK they`d get it later and the 4 of them started a discussion about what hospital I wanted to go to since we were located midway between two of them. I said I didn't care I`d go wherever they thought. My brother started telling them he didn't want to go to Bay View as he had had problems there whenever he took his former girlfriend there for things and they had a lighthearted exchange for a minute or so about the hospitals and decided to take me to John`s Hopkins. The whole time this was going on I was just laying there rubbing my left arm which was hurting more and my hazy fog seemed to be getting more pronounced. It`s hard to describe but I was viewing everything in a dreamy sort of way. I can only assume my heart was close to shutting down at that point and my blood pressure and oxygen levels were getting low. I suppose I should have been more forceful describing what was happening to me and asking for assistance but at that point I wasn't thinking to clearly and just reacting by instinct. Finally they asked if I was ready to go and I think I said yes and they asked me to find some shoes so I got up from the sofa (With no help) and went over and found the easiest pair of shoes to put on that were by the door. Once I had them on I waited until they reminded my brother where they were taking me. They asked if I could walk and I said yes and we started outside. When we got to the 3 steps heading down from my home to the sidewalk one of the Paramedics said to let them know if I needed help. It`s only a few steps from my house out to the street and I got into the back of the waiting ambulance. Once inside one of the men instructed me to first sit and then turn sideways to lay back on the little bed/stretcher thing which I did. At this point things become confused a little for me but from talking with my brother and nephew I was able to put together a good timetable of events later. After getting in the ambulance and laying down I seem to recall almost immediately sensing things start to become very "dreamlike" and the men's voices seemed to go farther away. I felt a sudden flush of my face and got that spinning feeling one gets right before you faint or black out. I said out loud "I feel like I`m going to pass out." and the one man who was the firefighter trainee said "You look like you`re going to pass out." which prompted the other man to say "Just lay back and relax and..." That`s all I remember hearing because suddenly I just was over come with extreme vertigo for a second and things went black. I had suffered Sudden Cardiac Death. I was gone. I experienced none of the classic "near death" phenomenon. I was simply in an empty black void. No bright light. No feeling of peace and contentment. Just nothingness. Like a deep dreamless sleep.
(A quick side note: At this point something went terribly wrong. Appearently it took the paramedics several minutes to notice that I suffered Cardiac Death. I think it was the perfect timing of me lowering my head back onto the pillow as the man said, "Just lay back and relax and..." which caused them to assume I was simply following that direction when in fact I had gone into cardiac arrest. Plus they had already made the assumption that everything looked ok and I wasn`t yet hooked up to any monitoring equipment. Thankfully they reacted in time to save me.)
From what my brother has told me after I was in the ambulance he had gotten in his van and gone down and made a U-turn in the street with the intent of following the ambulance to the hospital and was parked there waiting for us to leave. He said he suddenly saw the driver jump out of the ambulance and run around to the back and climb inside.A few minutes later a fire truck had arrived on the scene and several of the firemen quickly got off the truck and ran over to the ambulance and climbed in the back also. (One of the firemen took over driving the ambulance later) The next thing I remember was hearing someone calling my name from what seemed like a ways off but which I`m sure was right over me. I remember opening my eyes and staring at the ceiling and taking a few seconds to remember where I was. I still had that "dream like" feeling and also the feeling that I was right on the edge of blacking out again. There were more people crowded over me than I remembered seeing before and they all seemed to be very busy and were talking quickly among themselves. Someone lifted my head a bit to adjust an oxygen mask on me and I remember seeing one of the firemen standing at the backdoor of the ambulance looking in and he had such a serious concerned looked on his face. The voice calling my name asked me to answer and I said something but can`t recall what and then it started asking me if I knew where I was. My eyes darted around to verify I was where I thought and I said "ambulance". This became the pattern...Questions and one word answers..."Do you know what day it is?"..What day is it?.."Saturday". Apparently I answered all the questions satisfactorily. While this question and answer exchange was going on people continued to move around above me, lifting my arms, adjusting various tubes and wires.
The feeling that I had earlier in my room that I was dying was even more pronounced at this time. Even though I had no idea at that time that I had just been shocked back to life the way everything seemed so dreamy and the sounds so distant plus the haste and manner of the people working above me told me I was right on the edge between life and death. It was the worst moment and feeling of my life. I could just sense in the air that these people were struggling to save me.
My brother says the ambulance sat there 15-20 minutes after I got inside but I don`t recall that much time going by. I remember having to throw up a few times. Finally I felt the ambulance start to move and we were on our way. Several times during the trip I remember starting to close my eyes and drift off but that voice would start calling my name and was saying "Stay with me." So I focused all my energy on keeping my eyes open and staring at the ceiling. I remember thinking to myself; "If you close your eyes you`re going to die". The trip was fairly uneventful. I listened to the men in the back of the ambulance talking among themselves and talking on the radio to the hospital. I forget most of what was said but do recall several statements directed to me specifically, that I was "a lucky man" and "You scared us". The only other comment I recall was one of the men saying they had never seen anyone go thru defib while they were still awake and that it was "freaky". My only other thoughts during the trip was that all this wasn't really happening. As I said I had never had an injury in my 46 years beyond a sprained ankle and I kept thinking that this was all some horrible dream and I was wishing I would awake from it soon.
Finally they announced that we had arrived at the hospital and I recall being wheeled in thru a door and down a hall to an elevator where we waited maybe 10 seconds and someone said that elevator was being worked on so the rushed me down a hall to another small elevator which seemed to barely contain us all. We came off that elevator and went down another little hallway and into what looked like an operating room. A couple of people slid me off of the stretcher and on to the operating table and a number of people asked how I was and various other questions about my health and what medications I was taking etc. One of the men told me they had to remove my bottom but not to worry as they would keep me covered up (Unknown to me my pajama top had been cut off of me at some point but I have no idea when. Perhaps when they had to shock me. They gave it back to me upon my release and I have it hanging in my closet. It was sliced up the left sleeve and down the left side). Finally one gentlemen leaned over me and asked me something and although I completely understood the question I just laid there staring at the ceiling and didn't answer. He asked again and again I heard him and understood but didn't reply and he called out that I was "non-responsive" and that they could go ahead. I heard and understood this also...The next thing I remember I was in a hospital room in the CCU later in the day but don`t recall going from the operating room thing to the CCU.
I spent 5 1/2 days in the hospital and was out of work for 3 weeks. The main doctor overseeing my case while I was there told me that the echo test showed I had "a rather severe heart attack". I realize that I am very very lucky to have survived at all...From the moment I felt my first mild symptoms to the time I went into cardiac arrest was less than 25 minutes...There are so many things that could have happened that day... So many choices I could have made just slightly differently any of which would have resulted in my death....It was determined that the cause of my heart attack/cardiac death was blood clotting from my Hormone Replacement Therapy which had almost completely blocked my LAD...Hopefully I have not shortened my life considerably because of this...My only wish is that I can maybe save another from my fate and that I never ever forget what happened to me and how close I came and take life for granted.