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A Medical Adventure

“Ladies and gentlemen, we have a passenger needing medical assistance; if there are any passengers on board with medical training, please ring the call button above your seat.” As this announcement on our redeye flight from Anchorage to Denver vaguely registered in my semi-conscious state I realized that I was the passenger needing medical assistance. After a week of amazing adventures in Alaska the flight home turned out to be even more adventurous.

My wife and I had chosen the redeye flight because it was the only direct flight going back home and it would allow us an extra day on our trip. I had been sleeping for over an hour when I remember sitting up to change positions. The next thing I know my wife was asking me if I was OK, telling me I had passed out into the aisle. When I passed out again my wife rang the flight attendant, prompting the announcement. I passed in and out of consciousness but heard the announcement and became aware of several people standing over me. One was the flight attendant, another was a former Navy medic, and another was a nursing student who also had years of veterinary experience. At least that’s what we found out later. All I knew is that I felt like angels were watching over me.

My medical team was unable to get a pulse but my Fitbit watch read as low as 38 beats per minute. They asked me if I was feeling chest pain (I was not), what I had eaten or drank last, and what medications I take. We were over a remote part of Canada at the time so diverting was not an option. A medical kit was available and they were patched through to a doctor on the ground who recommended oxygen and an IV. The nursing student knew how to administer the oxygen and IV, which stabilized me until we arrived in Denver where paramedics would be waiting.

The flight crew requested all other passengers to remain seated so the paramedics could assist me off the plane. We extended a brief word of thanks to my medical team and I was able to walk to the door but then escorted by wheelchair to the gate where I was given a quick EKG and loaded onto a gurney. We went down an elevator and outside to a waiting ambulance that took me to the University of Colorado Hospital. Another EKG, another IV, and a blood test, along with an examination resulted in a diagnosis of dehydration and I was released to go home.

Although we were very thankful to have made it home, the dehydration diagnosis didn’t sit right. I had told all the medical personnel that I had a spicy sandwich for dinner the previous night and had drank two Solo Cups of water with it. My wife had thought I was dying on the plane and my medical team on the plane certainly thought it was serious, so the idea that I just needed to drink more water seemed surreal.

Nevertheless, I rested and drank plenty of fluids that day and felt totally normal the next day. I followed up with my personal doctor later that week and checked out fine. However, due to my lack of confidence in the dehydration diagnosis and my family history, he referred me to a cardiologist.  A few days later, the cardiologist did more EKGs and a stress echocardiogram which was normal. She said that my heart was very healthy, but asked how I felt about wearing a heart monitor for 30 days. Knowing that after what she went through my wife would want me to be absolutely sure, I said yes.

The next morning, I received a grave message from the cardiologist that my heart had stopped for several seconds during the night and I needed to see an electrophysiologist right away. An appointment was set up for that afternoon. Another EKG and brief examination resulted in a new diagnosis: sinus arrest and vasovagal syncope. The doctor said because my heart was stopping during sleep and I was sleeping upright on the plane, my brain was not able to get enough oxygen so I passed out. He said if they had been able to lay me down flat I would have been fine, but because I remained in my seat I continued to pass out. The remedy for my condition was a pacemaker, but after answering a number of questions he said it was not particularly urgent and I should go home and talk it over with my wife. I asked if there was a chance my heart would stop and not start again, but he said no, the real danger is that I would pass out again while driving or at the top of the stairs and cause injury to myself and others.

I went home and discussed it with my wife who was understandably very much in favor of the pacemaker, but I had my doubts. Despite my family history I’ve been a runner for many years with a resting heartbeat of 50. I felt like I was too young and otherwise healthy to have a pacemaker. Even the electrophysiologist called me a “relatively young man.” Surely there was some other contributing factor. Google did not turn out to be my friend as the more information I gathered, the more confused I became. My wife was waking me up at night to make sure I was OK and at her urging I scheduled the pacemaker procedure, but my doubts continued. A few things gave me the confidence to proceed. The original cardiologist I had seen followed up with me and confirmed that the heart pauses were still happening. She said she would keep calling me until I got the pacemaker. I also returned to my personal doctor, who answered all of my questions and confirmed the diagnosis. He knew the electrophysiologist and said he was good. He said not only was it going to continue to happen, but it would probably get worse.  I trust my doctor and felt better about proceeding after talking to him.

So the next week I became a member of the pacemaker club. The surgery and recovery were more painful than I expected, but I have no limitations going forward. In fact, the pacemaker has given me confidence to resume traveling and running and hiking and all the other activities that I enjoy. And my wife is sleeping much better.

If we had not chosen a redeye flight which caused me to pass out on the plane, and if I had not continued to question the dehydration diagnosis, and if my doctor had not referred me to a cardiologist, and if the cardiologist had not suggested I wear a monitor, then I would not know the condition of my heart. If the cardiologist and my doctor and my wife had not been persistent about convincing me to go through with the pacemaker procedure, I would still be at risk of passing out again, maybe in a more hazardous circumstance.

This medical adventure taught me several lessons. One is the value of having a primary care provider who knows your health history and can coordinate your treatment with other medical specialists. Another lesson is the importance of advocating for your health. You know your body and you play an important role to communicate what you are feeling to your medical provider. Asking questions and clarifying information can help you and your medical provider arrive at the proper diagnosis and health outcomes.  And then you have to follow through with their recommendation even when it’s not what you want to hear.

I am thankful for the medical care I received and thankful to work for an organization that helps people with access to medical care. You never know when you may be the one needing medical assistance. It is nice to know there are medical professionals who are trained and willing to help. As far as I’m concerned, they are angels.