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Heart Rehabilitation for Diane Davis Andrew last updated 20 October, 2018

Narrative below of heart attack & treatment; status after year, 3 years, 5 years7 years10 years

Overview of Diane's Heart Attack & Treatment
On Jan 11, 2008 Diane had an acute myocardial infarction - 70% blockage of right coronary artery - from a blood clot formed from eruption of lipids after a vulnerable plaque rupture (see video). The duration of heart muscle oxygen deficiency was reduced by >30 minutes by receiving half the FDA dose of clot-busting Retavase in ambulance vs. in the hospital, part of a UT clinical trial.

This artery had experienced uncommon separation (dissection) of the interior flow area from the artery wall, that caused blood to flow down a newly created "false plenum" which had the effect of partially collapsing the "true plenum". This artery now has only 10% stenosis after being fully reinforced with SEVEN expanding mesh titanium stents. These Liberté-brand stents by Boston Scientific were positioned to allow all the smaller arterioles to still feed oxygenated blood to the right ventricle. (Note her two other coronary arteries displayed no problems)

Read detailed chronicle below of heart attack, treatment, monitoring & rehabilitation for a month.

Friday Jan 11, 2008
The afternoon of Jan 11, 2008 Diane was at Church of the Redeemer with Dick Bird, getting music ready for a new Friday night service. Suddenly she felt sharp pain spread to her jaw and  left arm so Dick called "911". Our Rector Rev. Nan Doerr was already on her way over to church and saw two ambulances go by, and got there in time to help EMS gain access into the building.

The Emergency Room's were full at St. Joseph's, St. Luke's and Methodist hospitals. Fortunately Memorial Hermann has a new process that gets patients directly to Cardiac Catheterization Lab, bypassing their ER procedures. EMS crew immediately began treatment while Diane was being transported. They did not wait for any of the required health insurance forms to be filled out - support staff arranged for all the forms for patient "Yankee1229" (her hospital code name for the first 24 hours) to be bought to Bob when he arrived!

UT Med School interventional cardiologists over several hours used minimally invasive procedures that started out with a coronary angiogram: live X-ray images captured on digital video which shows arteries using radio-opaque contrast injected, followed by a catheter inserted through a groin incision in the femoral artery. This first catheter procedure used a live video camera which is how Dr. Ali Denktas discovered the extent of the problems in the right coronary artery. The team did the stent placements guided by the live imagery. Early evening she was transferred upstairs to the CCU of their Heart & Vascular Institute. Bob stayed in the CCU for several hours filling out detailed medical history required, then slept in the waiting room.

Saturday 12 Jan 2008
In the early morning hours a Resident removed the heart catheter which had been preventatively left in, as a precaution after the procedure. Later that morning a full echocardiogram was done of her heart -from four angles - to look if any areas of heart muscle were not fully responsive to the electrical rhythm of the heart. She will get an initial opinion on Sunday, but the doctor warned it might be six months before they fully know if the MI caused any permanent damage, comparing the enzymes and heart function. Diane has EKGs performed several times per day. If all is still well Sunday, she will transfer to an intermediate cardiac care  room.

The doctor advised she can resume her job within a week, which doesn't involve lifting more than 5 lbs. While in hospital she is on Aspirin, Beta-blockers, Lipitor, Plavix and Protonix

Sunday 13 Jan 2008
Her doctor reported no problems with any of the diagnostics they had performed, and only made adjustments to some of her intravenous medication. He used the phrase "perfect" and teased why wasn't she in her chair (because it was too low compared to the bed). The "markers" in her blood that occur after an MI were coming down as expected, so he arranged for her transfer to Rehab, which will start Monday Jan 14. She was moved to Room 352 of Cullen Pavilion.

Monday 14 Jan 2008
Diane begin doing in-hospital rehab walking exercises, but was not able to do closed cardiac MRI - and there is no open MRI for hearts.  Diane was referred for out-patient Phase II cardiac rehab near our home, at Memorial Hermann South-East. She was given full details of the Retavase trial agreed to on Friday, with phone call follow-up to occur monthly for a year.

Tuesday 15 Jan 2008
She was discharged after lunch, received a written report of the cath. lab procedure, prescription for medicines with literature on each, and written advice about diet and lifestyle. Bob signed her up for Clear Lake Community Ass'n low-impact aquatic exercise classes Tues/Thurs 8-9 am for her knee health and weight loss, and got map directions to her twice-weekly cardiac rehab.

Saturday 19 Jan 2008
Diane has stayed home this week, getting up each day, and doing small things around the house (making tea, feeding dogs, washing dishes) and looking forward to being driven to church Sunday.

Sunday 20 Jan 2008
She sat in the congregation, joining in the hymns and prayers, staying afterward for the annual parish meeting and lunch before going  home for a nap. She and Bob have decided to switch to evening aquatic exercise on Tues and Thurs so they both can do it, once she is cleared to do exercise other than supervised cardio.

Friday 25 Jan 2008
Diane's sister Joanne drove her to cardio rehab where she worked out on the recumbent bike. Her next appointment with her cardiologist is January 29, to get cleared for driving.

Thursday 31 Jan 2008
Had a follow-up appointment with her catheterization doctor, who has cleared her to drive and go back to work. She's working two days/week from 10 am to 2 pm, i.e. half as many days as before.

Status at Three Months
Diane was in cardio rehab three times per week; back at her Admin. Asst. job at church Monday, Tuesdays & Thursdays, and taking part in prayer group and church on the weekend. She has a Schwinn recumbent exercise bike and upper-body tabletop machine to do rehab at home.

Status After One Year
Diane chose to step back from working 20+ hours per week in the
Church of the Redeemer office. She still composes the Sunday bulletin from home using Publisher, and she also sets the weekly service music to fit on half-page using Sibelius. She is enjoying driving our five-year old grandson Brian to and from school, and taking her elderly aunts lunch each week.

Status After Three Years
We live in Dubai with excellent health care, great insurance. Her cardiologist at American Hospital says her health is excellent, blood pressure slightly below normal, not a sign of problems!

Status After Five Years
Back in Houston, arriving after political party Conventions and election debates, which included Liberal and Conservative policies about under-insured. There's apparently a "Texas High-Risk Pool" for pre-existing conditions, but accessing it has been rather daunting for Diane. She found herself in multiple websites and/or (800) phone hell: (dial 1 for ...) never getting to an actual human being! Apparently there are physical offices we can go to, but they're NOT listed on their website.

Status After Seven Years
On 28 June 2012 the US Supreme Court upheld the PPACA Patient Protection and Affordable Care ("ObamaCare") Act passed in 2010, which stops patients from being denied coverage from a pre-existing condition. Diane has since been able to get all of the medical care she needs through conventional insurance, although had to wait until employer coverage improved in April 2013.

Status After Ten Years
Diane is on Medicare Advantage, with great care through Kelsey-Seybold clinics, with a designated primary care physician and an experienced cardiology specialist.