The time is just past 3am. No, I’m not a night owl, I’m on the clock. I’m called into a patient’s room for complaints of “a pounding in his chest.” A glance at the telemetry monitor on my way to his room shows a beautiful sinus rhythm. Reassuring, but Nursing School 101: assess the patient first. He’s resting comfortably but his face looks terrified. He feels a constant throb from his head to his toes. Lub-dub, Lub-dub, Lub-dub. He is 4 days out from getting his chest cracked open – a quadruple bypass. Our specialty. I talk with him about his symptoms and he already seems at ease. The hour long conversation that follows leads me to believe that there is more to it than just a thumping heart, he needs to talk.

He had “The Big One.” Severe chest pain, tingling in his arms, headache, profuse sweating. A cardiac catheterization gave way to words that you do NOT want written in your medical record. “Chronic total occlusion” and “Complex multi-vessel coronary artery disease not amenable to PCI.” In layman’s terms, the blockages are so bad they cannot be fixed with stents because there’s no where to even begin. Percentages are thrown around – 85% Left Main, 96% LAD, 90% Circumflex. While these may seem like passing scores, they are far from it. These percentages are telling of how blocked the arteries feeding your heart are, and where blood is NOT able to flow. Scary stuff. Like many of my patients, he has gone from reading the paper with his morning coffee to facing questions about his own mortality in just moments. And like many nights, I find myself standing at the bedside hashing things out at 3am.

This conversation stuck with me above the rest. For the last several years he had been bringing up concerns to his primary care doctor. No, he understandably wasn’t doing what he was when he was 30 but he knew he shouldn’t be feeling this run down all the time. He wasn’t as peppy as he wanted to feel. The response was, “you’re getting older” as if aging was synonymous to frailty, chronic fatigue and nursing homes. I don’t buy in. Neither did he, although he was admittedly ashamed of the way he treated his body over the years. In his defense, he grew up alongside Wonderbread and the amount of both knowledge and education on the subject of whole foods was negligible. Lucky for my generation, we are far beyond where he began. That means we can rewrite the story going forward… doesn’t it? Information is at our fingertips yet heart disease is still the #1 leading cause of death across the globe. Hmm, seems to be a disconnect. There are certainly genetic components, but there is no arguing that that the conventional American diet is the driving force. The reality is, it starts with your habits, with every action you take (or don’t). But first, you must accept responsibility for these actions. Who you are is a direct result of the decisions you have made. If you want something to be different, you have to DO something different.

It won’t be my story, and it doesn’t have to be yours.

Back to the throbbing heart. For once, this was a good throb. This was a new lease on life. I explained that his heart and body were adjusting to its new normal. This is the feeling of proper perfusion and adequate blood flow and it often comes as a shock to a heart that has been compromised for so long. But not everyone gets this second chance. It’s up to you if you want to take that risk. If I’ve learned anything from bedside nursing it’s that hindsight is 20/20. Most of these patients are eager to share the regrets and newfound wisdom on life and health in hopes to spare their young 23 year old nurse from following their footsteps. But the reality is, knowledge means nothing until it is applied and it comes down to one action, one choice, one decision at a time.

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