November 8, 2004

At 6:45 am, while at work, Patty experiences chest, arm and back pain, and makes her way to the school office for help. EMTs are called. When I arrive, EMTs tell me not to worry, because the problems are not with Patty's heart -- instead, they offer that Patty is likely experiencing a "panic attack." Upon arrival at Rush-Copley Hospital, we learn she is having a massive heart attack. Within moments, she is rushed to the catheterization lab for an emergency angiogram. Doctors discover that her left anterior descending artery, the largest artery to the left ventricle, is 100% blocked at the top -- this means, in essence, that a huge portion of Patty's heart is starving for blood. Doctors often refer to this type of heart attack as "the widowmaker" because it is often fatal. An emergency angioplasty is performed and a stent is placed. Extensive damage has been done to Patty's heart, but doctors are optimistic some function will soon return.

November 12, 2004

Patty is released from the hospital and begins cardiac rehabilitation. At first, she can walk less than a block without becoming totally exhausted. However, each day seems to bring some minor increase in energy levels.

November 30, 2004

Doctors make adjustments to Patty's medication because of blood pressure so low it makes her dizzy and faint. Unfortunately, beta blockers and ace inhibitors, which she tolerates poorly, are key to protecting a damaged heart. At this point, her ejection fraction (a key indicator of heart function) is at 20-25% (normal is more than 55%). She is diagnosed as suffering from heart failure, although doctors still believe she may recover heart function.

December 6, 2004

To get a second opinion about the condition of Patty's heart, and to get thoughts on future needs, we visit with Dr. Silver, a renowned heart failure specialist, at Advocate Christ Hospital. Doctors diagnose Patty's heart failure as severe, but manageable.

December 7, 2004

We meet with an electrophysiologist at Rush-Copley. The doctor agrees that an ICD (implantable cardioverter defibrillator) may make sense for Patty within the next four months or so, but advises that we should not rush things because Patty's heart may still make progress and the device is very expensive.

December 15, 2004

While at a routine follow-up appointment at the Rush-Copley Heart Center, Patty has a pronounced heart failure episode (faintness,shortness of breath) and is admitted to Rush-Copley. Doctors are somewhat concerned that her heart rate is only in the high 40s for beats per minute. Cardiologists suggest that we be patient in considering any major future interventions, because they believe Patty's heart may still recover.

December 16, 2004

At the urging of a nurse with whom we have personal contact, we again visit Advocate Christ Hospital to get a second opinion about whether Patty's heart failure is currently manageable. At the time, Patty is feeling pretty well, so Drs. Silver and Slaughter initially think she will be released within hours. However, after a precautionary echocardiogram and angiogram, doctors determine her condition is much worse. In a hallway conversation, Dr. Silver asks, "How many children did you say you have?" Over the next few days, much discussion ensues about what is the next best step. Ultimately, doctors decide it will be best to implant an ICD/pacemaker -- at this time, though, more for its pacing abilities than for the ICD protection.

December 21, 2004

Doctors place an ICD/pacemaker in Patty to help increase her heart function and protect her against sudden cardiac death. Patty's heart rate is now paced at 70+ beats per minute.

December 22, 2004

Patty is released for the holidays

January 3, 2005

Patty returns to work on a part-time basis -- her first day back since the heart attack.

January 17, 2005

Patty cuts her hand with a knife while scooping wax out of a votive holder. She is stitched up. Doctors are concerned at the time because Patty is on blood thinning medication that reduces clotting factors.

May 8, 2005

Patty visits Rush-Copley Hospital because of discomfort in chest, shoulders and arm. X-rays and bloodwork are normal, but doctors keep her overnight and schedule an angiogram as a precaution.

May 9, 2005

Doctors discover that Patty's LAD artery is 80% restenosed (blocked). The cardiologist places a drug-eluting stent, which is difficult to place because of the "fibrous" nature of restenosis. Patty has a minor second heart attack during the procedure. At the time, Patty's ejection fraction is believed to be in the 35% range, a slight improvement from the time of the heart attack, and most likely the result of the pacing of her heart.

May 11, 2005

Patty is released from the hospital. She continues to work part-time through the end of the school year, and then returns in the fall on a full-time basis.

February 10, 2006

After a few months of regular exercise, Patty visits Christ Hospital for a routine stress test, and passes with flying colors.

February 23, 2006

During a visit with cardiologists at Christ Hospital, Patty is given a clean bill of health (for a person with heart failure). Doctors are impressed by how healthy she appears. Patty discusses occasional arrhythmias she has been experiencing, and is told to visit an electrophysiologist at Rush-Copley.

March 27, 2006

We visit the electrophysiologist at Rush-Copley to discuss recent arrhythmias. Patty is given a heart rate event monitor for 30 days to track arrhythmias more precisely. The doctor suggests that perhaps an electrophysiology (EP) study, in which electrodes stimulate sections of the heart to reveal possible sources of odd rhythms, might soon be in order.

April 6, 2006

Patty is called from school to the electrophysiologist's office. The doctor is concerned that arrhythmias that have appeared on the monitor may be dangerous. He recommends moving up the date of the planned EP study.

April 13, 2006

Doctors at Rush-Copley conduct an EP study on Patty; although Patty is in the procedure for several hours, doctors are unsuccessful at provoking an arrhythmic event.

April 17, 2006

At the encouragement of a family friend, Patty visits Dr. Goodwin at Edward Hospital. We are immediately impressed, and make plans to transfer all care to Edward Hospital. The doctor orders Patty's records from Christ and Rush Copley. He also arranges an appointment with Edward's EP department to have Patty's ICD read.

April 26, 2006

Patty's ICD is interrogated at Edward Hospital. Findings reveal a great number of arrhythmias have taken place, but they have dropped off sharply since the EP study.

May 9, 2006

Patty has a terrible night while sleeping. She feels intense pressure in her chest and has profound difficulty breathing. She feels nauseous and weak in the morning, but feels compelled to go to work. After a very short time at work, Patty leaves, feeling to ill to do her job. We call Dr. Goodwin. He adjusts Patty's medications and asks Patty to call him the next day if there is no improvement.

May 10, 2006

Patty experiences no improvement. We see Dr. Goodwin, who immediately admits Patty to Edward's heart hospital. An echocardiogram is performed that afternoon, which reveals a major drop in ejection fraction, to less than 15%.

May 11, 2006

An angiogram is performed to take a closer look at Patty's heart. The results verify the finding from the echocardiogram. Dr. Costanzo, who specializes in advanced heart failure, is called in to consult on next course of action. She explains that Patty's heart is truly failing. Dr. Costanzo talks to us about two possibilities -- the Dor procedure (a reconstruction of a section of the heart) or transplant.

May 23, 2006

We go to Edward for a stress test. At the time, Patty is feeling very poorly. I insist that Patty be evaluated by a medical professional. Dr. Constanzo comes to see Patty and admits her to the hospital. Later that day, she arranges Patty's transfer to University of Chicago for transplant evaluation.

June 22, 2006

Patty is added to the heart transplant list at Status Level 1A