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••• The International Writers Magazine: Matters of the Heart

A Close Shave
• Lionel Darmendrail
Surviving a heart attack in France


This was Friday evening. I had a few first year students at home while Catherine had gone to Paris with nephews Allan and Adam who had spent two weeks with us in Biarritz for their Spring holiday.

We were having a good time as usual, drinking, eating (the girls had brought some delicious home-made desserts, along with flowers for Catherine), smoking, socializing and--most important-- carrying on in English. The main reason for such 'happenings'.

Catherine and I had been invited at my brother's for lunch the preceding Sunday after having spent the whole morning cleaning the house in Hasparren before guests arrived. As usual, we had a big family meal. Champagne à gogo, Château Chasse-Spleen, digestifs... you name it.

We left the table at about a quarter to 4 pm. While getting to our car in the alley, I felt a characteristic pain at the top of my chest. Something like a high pressure, some sort of inside radiation. I instantly thought of a heart problem. Catherine at the wheel suggested that we drove to the Aguilera clinic nearby, but I told her I'd rather go home, lie down and see what happens.

After 15 minutes in bed and Catherine gently massaging my chest and feeling my heart, the pain disappeared and I fell asleep. I slept well throughout the night.

The next morning, I drove to the clinic in Biarritz where I was expected to have a cardiac stress test which had been planned two months earlier and scheduled at ten in the morning. The timing couldn't have been better. When I told the cardiologist what had happened to me the previous day, he immediately cancelled the test and asked me to follow him to the emergency room where I had an electrocardiogram and a blood test.

A moment after, he told me that the ECG was 'normal' but that my blood sugar/glucose level was high and that I should see a diabetes specialist (my family physician had indeed detected some early signs of an incipient type 2 diabetes about a year ago, but after a dietary regime imposed by my wife--and no medication--my diabetes was stable and balanced, with no complications for all it seemed). When I asked the cardiologist if diabetes could explain the pain at the top of my chest, he just shrugged his shoulders and said: "Who knows?"
I won't ask for him again.

So, that Friday night, we were all on the terrace, Adèle, Annie, Louison, Victor, Ivan and me, shooting the breeze and enjoying the music (Lou Reed & John Cale's 'Songs for Drella', Ry Cooder & Manuel Galban's 'Mambo Sinuendo'...) talking about books (Charles Bukowski's 'Uncollected Stories and Essays' and John Cale's 'What's Welsh for Zen'?) and tasting my home-made Patxaran (one of the highlights of the meeting) when I suddenly felt the same pain at the same place inside my body.

Holy shit! Another warning shot. I quietly waited until the symptoms somehow vanished after about five minutes. And, as if nothing were wrong, I was once more totally engulfed in the conversation, standing up, listening, encouraging and fostering the ability of the most shy of my students to speak it out and talk about their own experiences and feelings... I nodding in agreement, correcting some wrongful uses of words when necessary... taking it easy, laughing together.

I usually insist in class on their capacity to describe the works of art they're producing at school. They all know that if they want to spend their life within the wide and wild world of art, they'd better communicate in English. And, here and there, I'm trying to do my job the best I can to help them out. And where there's a will there's a way, right ?

Soon after Catherine called at 11:30 pm to wish me good night, the pain resumed. I told my art students I was a bit tired and that I had to be in Hasparren early in the morning so I'd better hit the hay. While they were getting ready to take leave I was almost doubled over in pain. The students were worried and offered to take me to the nearby clinic at Aguilera. I told them it was alright, it had happened before and that it would pass after getting into bed. It didn't.

I stayed lying down without sleeping for a couple of hours with the pain persisting. At 2 am, still awake, I thought it wasn't wise to keep going like this. So I dialed #15 (SAMU or Urgent Medical Aid Service) and got up to get dressed before the ambulance came.

I waited about 15 minutes. As soon as I saw the flashing blue light illuminating the dark night, I locked the door and walked out to the street. Two young people, a man and a woman got out of the vehicule and came to me. "Are you alright?" I heard the girl on the phone saying: "the patient was standing up outside in the street when we arrived on site". They then proceeded to extract the metal stretcher from the back of the van but it didn't come out easy.

Once it was on the street--it had started raining by now-- they tried to lift it on its 4-wheeled legs but it kept falling down flat. Eventually, when the unfolded legs came up and stood to hip height, they instructed me to lie down, face up, on the stretcher, which I did. And when I did, the bed suddenly folded on itself and fell down on the tarmac. "Sorry for that. Are you alright?"

They put it up again and attempted to introduce it into the ambulance. Head first, but it somehow refused to squeeze in. They shook it from one side to the other, pushing at the same time. As the bed finally rolled in inside the vehicule, a first aid case fell from the top side onto my body.
A real farce!

The girl asked for my 'carte vitale' (which contains all the administrative information necessary for the reimbursement of treatment costs). Told her I didn't know where the card was but I knew the pain in my chest was pressing.

All in all, I'd say the ambulance had been there, in the middle of the street, some 15 minutes and nothing going really. They had neither taken my pulse nor checked my condition one way or another. It dawned on me that this pair were probably not nurses (DEA), but just a driver with a probable trainee (the guy's girlfriend?). Then, I heard one asking the other: "Where shall we take him? Aguiléra or Bayonne?'' (Had I known better then--as I do now--I'd have told them: 'Straight to Bayonne, please!'). ''Let's take him to Aguilera; it's on the way'' was the answer.

They disembarked me in the same emergency room where I had an electrocardiogram the previous Monday. They said good bye and drove into the night. The time was half past two am. This time the premises were deserted and here I was, flat on my back, alone in the dark.

After a while, a young and very pale, ghost-like nursing assistant silently took my pulse and introduced a needle into my arm for a blood test. I asked him where the emergency doctor was. He said he himself was doing his job, first aid, and then he was going to call the doctor on duty.

Moments later, a mean-looking guy with messy hair appeared, masticating a piece of food, and said: "I'm the doctor in charge; what's your problem?" After I had told him, he just added: "I'll perform an ECD on you", and, with the help of the nursing auxiliary, they started sticking patches on my arms, legs and chest and connecting them to the leads from the electrocardiograph machine.

After another while, the same fellow came back in front of me and said: "I'll be honest with you... ("This is it! The real bad news" I thought)... I'm not a cardiologist... and there isn't much I can do for you... but I can call an ambulance to take you to the Intensive Care Unit in Bayonne". I felt somewhat better, still floating between two waters. He then put something quite bitter into my mouth, "to alleviate the pain" he said.

Meanwhile, the young assistant informed me he was going to take another blood sample to check my blood sugar level; he also pricked my other arm to put me on a drip. I was still lying in the dark, awake, wondering if I would get better and how long would all this take.

It took quite a while. Semi-conscious, I emerged at the ICU at 5:30 in the morning. From then on, everything worked out fine without any loss of time. Getting prepared for the operating room, I was immediately given a variety of services by the nurses on duty, such as blood pressure and heart rate checks, an intravenous drip as well as several injections.

One male nurse came to me for another blood test and almost lost his temper: "They've fucked up again; it's not the first time and it drives me mad. You've had your blood drawn twice already, one in each arm for measurement of hemoglobin, coagulation profile and sugar levels... but they never checked--as they should have-- your blood group and type, necessary for the operating room... so I'll have to jab you again."

At about nine o'clock, after having undressed and put on a hospital gown, I was taken to the surgical suite in the basement where the operating room team (5 people altogether) were getting ready. The anesthetist, a nice looking woman with an accent (she was from Bulgaria) gently told me that I shouldn't feel any pain and gave me a local anaesthetic to numb my wrist.

Then came the surgeon, Dr Pachebat, the same person who had operated on me 13 years ago. He was closely followed by another younger surgeon who assisted him. And two other nurses. Some nice music was in the air and Pachebat told me I could visually follow the process on the screen above my head.

Stent insert During this procedure a.k.a. coronary angiogram and performed with the use of local anesthesia, a coronary catheter (thin, flexible, plastic tube with a diameter of about 2 mm) is introduced through the skin and into an artery in either the groin (via the femoral artery) or the arm (via the radial artery). A contrast dye, easily visualized with X-ray images, is then injected into the coronary arteries to check for narrowed arteries in your heart and find the origin of the existing chest pain.

*Note that the coronary arteries, which supply your heart muscle with blood, can become clogged from a buildup of cholesterol or other substances such as 'plaque'. This can reduce the flow of blood to your heart. If a blood clot forms and blocks blood flow through that artery, a heart attack may occur.

Once the cardiologist has identified a blockage shown in your 'coronary angiogram' and found out if it is suitable for 'stenting', he will perform what's called a 'coronary angioplasty', i.e. the placement of a stent in the clogged artery to keep it open and let the blood flow.

Coronary angioplasty and stenting are procedures that open narrowed or blocked coronary arteries. In this procedure, the surgeon will widen your blocked artery with a balloon (angioplasty) and a small, wire mesh tube (stent) so that blood will be able to flow through the artery.
Then, when the stent is in place, the balloon is deflated and the catheter removed.
The procedure takes approximately 30 minutes.

For my part, the operation was carried out not only in music but also in a happy forum with soothing good humor and kind jokes. Later, when I mentioned my surprise to the anesthetist, she confided: "Unfortunately, it is not always the case; but yes, this team gets along well".
Whatever be the case, I was not at all worried during the whole process.
Before I was taken away from the operating room, Pachebat waved at me and said: ''See you in another 13 years!''

I was then moved back to the recovery area in intensive care to rest for 48 hours while my heart was monitored and I had to drink fluids via IV to flush my kidneys of the X-ray dye.

As I mentioned earlier, I was alone in our house when I dialed 15. Catherine was in Paris and I didn't want to alarm her in the middle of the night. So, when I later called her up Saturday morning and informed her of the situation, she told me she was not to wait until Sunday (her train was expected back in Biarritz at 4pm) but would come back asap. She did catch the first flight available and was next to me that same afternoon.

The cardiologist came to my room to explain what had been done. He also added that there were two small arteries that needed to be looked after and that I was expected back on May 23rd (tomorrow that is) to find out if I need another pair of stents.
Here I am now, hoping I get my chops back together for a while... and clinging to Catherine for dear life...

Biarritz, Tuesday, May 22nd, 2018

Lionel & Catherine
Lionel & Catherine before the new post op diet!

PS: The beat goes on!

Thursday 24th, and I feel somehow relieved: it turns out that, even if my arteries are clogged with 'plaque', my heart is strong and beats well.

As for my 'arterial plaque'--made of fat, bad cholesterol, as well as diabetes (high blood sugar)--there's no way really to get rid of it.

The main thing is to keep it 'elastic' so it doesn't turn 'rigid', and to do so, one must exercise regularly and maintain low blood sugar through a diet low in saturated fat and... inch'allah!

© Lionel Darmendrail May 25th 2018

Editors note: Lionel is a well loved teacher of English to art and media students in Biarritz, a wonderful papa to his children and I know all his many past students would wish him a speedy and full recovery.

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