Heart attack on the River

This is one of those stories that reminds us that you never really know what's going to happen next. It was Thursday, March 19, St. Joseph's Day, and the weather promised to be warm and sunny. I couldn't think of a better way to get away from people than by setting out in a canoe, so I planned a mini expedition up to Minnies Island, about two miles upstream. There is an abandoned house there that was once used by the Potomac Conservancy, and since it had been about eight years since I last visited, I thought that it would be a fun place to explore.

Minnies Island is not visible from Sycamore Island, there is a big bend in the river, so instead of hugging the Maryland shore I made a b-line towards the inside of the bend on the Virginia shore. Good birding all the way and I even saw some hooded mergansers that were now in their bright orange breeding plumage, a rare sight this far inland. Once I got past the lake-like water above the dam I had to fight against a pretty strong current. I hadn't checked the river gauge before I left and the river was higher than I had expected. Usually, if the river is over 3.5 I don't attempt to paddle upstream too far. I found out later that the water level was 3.8 and rising, no wonder it was difficult. No worries, it gave me a chance to try some alternate routes upstream and it was fun to hug the Virginia shore for a change, especially since there were a few hikers to wave to as they hiked along the trail at Turkey Run Park. I made it past the rocky point with the high cliffs above me on my left and soon I was paddling hard to get past one of the ridges that I needed to ascend in order to reach Minnies. It felt good to exert myself and get my lungs pumping. I took a water break behind an eddy and prepared for the next ledge. This ledge gave me a lot of trouble and I started to wonder about just how high the water was. The large volume of water forced me to traverse across the river, looking for an easier path upstream. By now I was working really hard and sweating. It was really starting to feel like an expedition as I was determined to reach my goal despite the ledges and pushy whitewater. I was forced to traverse back across the entire river, maybe 200 yards toward Maryland, until I reached the shelter of some small islands. There I was able to squeak through some small channels between the rocks and closer to my goal. I was pretty hankered by then but my destination was within reach. Just one more 100 foot channel to overcome. A group of crows greeted me and kept watch over me as I rested and listened to their chatter. There was an attractive looking sand bar on the far side, at the very bottom of Minnies, but I chose not to land there since the vines looked impenetrable. I crossed the channel and tried to paddle along the Virginia-facing side of Minnies but the current was just too strong and I had to land at the first tree along the bank that I came to. It was about 3:30 by then. Minnies is smaller than Sycamore Island but the banks are high and steep. I had to crawl up twenty feet to level ground and then I had to struggle through the jungle of vines that made it difficult to get to the upstream side of the island where the house was. I was amazed at how overgrown the island had become, but otherwise not much had changed since my last visit. When I reached the house I climbed the steps to the large deck and I peeked in the windows. I was surprised to see that there were still a lot of miscellaneous items scattered about inside; books, binoculars, bleach bottles and a pot bellied stove. There was also an EARTH DAY flag hanging by one nail outside, above the bolted door. I stood on a chair to pull it down and I stuffed it in my pack. I was pretty certain that no one would miss it. I ate my snacks and drank some water before I walked around the house to see what else I could find. There is a small cove next to the house and as I stood by the water I started to feel some discomfort in my chest. I brushed it off, thinking that it was just my lungs recovering from the trip upstream. I wasn't worried but I thought that maybe I should start heading back to Sycamore Island, since it had taken me longer than I thought it would to paddle up to Minnies, plus I had a good 30 minute paddle back. I worked my way back to my canoe and noticed some yellow ragwort flowers blooming on the bank, but I didn't seem to have the energy to dig out my iPad to take a picture. I climbed into the boat and let the fast current carry me back the way I came. It was 3:50 by then. I quickly passed by the two most difficult ledges, but I wasn't enjoying the rapids as I might have otherwise. I was starting to feel worse and found myself being reluctant to paddle. My phone made the noise that someone had texted me. I dug it out of my pack to see who it was but I didn't seem to have the energy to reply. My chest pain was getting worse by then, and I figured it would be a good idea to tell someone where I was and how I felt. There was no question, I had to call Mary. Thankfully she picked up the phone. I told her that I was experiencing chest pain and if she would be so kind, could she please call my cardiologist, just to see if they are open and around. We hung up, but I must have sounded distressed because right away she called me back, even before calling the doctor. Joe, she said, go to Lock Seven. I don't think that I was thinking very clearly at that point, and I told her that maybe I had already passed Lock Seven. Thankfully though, I realized that I was actually parallel with the lock, but still a few hundred feet out in the middle of the river. Yes, I said, I'll paddle to Lock Seven and meet you there.

That was at 4:00. While she was busy driving and calling the doctor I was fighting off the urge to take a nap. My body did not seem like it wanted to paddle and I sat there with limp arms for a few seconds. I was hoping that the river would carry me in the right direction, but I quickly realized that I needed to paddle if I wanted to get to shore. By now, with the pain radiating down my left arm, I was sure I was having a heart attack. I had felt this kind of chest-crushing pain before, back in 2016 when I needed my first stent, so even though that had not been an actual heart attack, I knew the signs and I guessed that I had over-exerted my heart in my ascent to Minnies. I could see the white of the lockhouse to my left but I had one more tricky ledge to navigate. I knew the slot that I had to hit and now I was very glad to have the extra water in the river to get me past that small and bony passage. I made it past the ledge, had to, but the pain by now was debilitating. Decision making and route finding were near impossible as I floated past one more tiny island to a place where I could see a low gravel bank. I gathered my strength and I went for it. Once the tip of my canoe touched the shore, I slid off of my seat and slumped down with my butt on the bottom of the canoe and my back resting against the seat. I waved and shouted to a lady that was walking her dog along the trail. I wanted someone to lead Mary to where I was. She wasn't much help. My phone rang and I instinctively picked it up. It wasn't Mary so I hung up and dropped the phone back down to the bottom of the canoe. Turns out that it was my cardiologist calling. Soon Mary arrived, she had no trouble finding me, and I was so happy to see her racing across the gravel bar. Even before she reached me I told her to call 911, I was having a heart attack.

Calling 911 from a mobile phone can be confusing for the dispatchers, but Mary knew what to say about our location near Glen Echo, and the dispatchers had the rescue squad from the Glen Echo Fire Department on their way. That must have been about 4:15. Right away we heard the sirens and Mary assuringly told me that that sound was for me. It seemed like a long time between the time we saw the fire trucks and the time the EMTs arrived at the canoe but it was still only 4:32 when they did the EKG on me while I was sitting in the canoe (after putting a mask over my nose and mouth, of course) My phone rang again and this time Mary picked it up. It was the cardiologist again who started asking about my symptoms until Mary told him that we had already called 911. It was amazing, Mary was on the phone with the doctor and with the dispatcher, who was on the line with the EMTs, directing them where to go. As it turned out, my cardiologist was the emergency doctor on call that day, so there was no hesitation, I was going to Suburban, even though Sibley might have been closer.

What a break. No hugs or kisses, my job was to sit still, I didn't even have the strength to open my eyes. I was awake and listening to the EMTs and it was amazing to hear them make dozens of split-second decisions. It seems that they may have deployed the river rescue guys too and there was another ATV rescue vehicle coming along the towpath. After looking at my scary EKG they gave me a nitroglycerin tablet to open my arteries and a few baby aspirin to chew on. They pulled me out of the canoe and onto the gurney and six of them carried me up to the towpath from the river and then directly into the ambulance. I was in a lot of pain and my breathing was very shallow. It reminded me of some of the survival stories that I've read and I just kept thinking that I just had to keep breathing and hold on. Strangely, I noticed that the pandemic meant that there was almost no traffic on the beltway and we got to Suburban lickety-split. It was hard to gather the energy to answer the EMTs' questions. I told them that I was 5'7" even though I'm 5' 6", only because I was getting it confused with my age of 57 years. They gave me an IV and an oxygen mask. Soon I was seeing the exit signs over me as they whisked me through all the doors into the emergency room where I was met but a large welcoming party including my surgeon. He seemed more concerned than I've ever seen him and in the elevator he told me it was the real deal this time. I nodded my consent so he could give me the catheter like the last time. Also, while en route, his wife called and I heard him tell her to do dinner without him, since his patient was in the middle of having a heart attack. It was very helpful for me to have gone through this procedure before, different circumstances of course, and I was just hoping that they could catheter me through my wrist (which they did) and not my groin, silly. They were cool, calm and efficient as I lay there groaning. I was less scared now, not that I had much time to worry anyway. I was on the operating table so I was pretty sure I was going to make it, despite the extreme pain.

The doctor kept telling me to hang on everytime I moaned and I kind of lost track of time. Before too long I could feel the warmth of the blood rushing back to my head and I knew that was going to wake up from this bad dream. As I regained some clarity I thought that they must have had to do another stent since the pain was not going away, but no. I recieved just the one stent, and surprising to me it was in the exact same spot as my first stent four years ago. It was 6:18 by the time I was wheeled into the recovery room. It was weird, I was only one of two patients in there. So different than the last time when I was just one of maybe two dozen outpatient cases. I suffered chest pain throughout the night which was normal considering everything but I was feeling good on Friday and they let me go home at 4:00.

I just need a week's rest and I'll be back to my normal activities! Wow!