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EHAC Moments
Heartfelt letters from Reader's Digest readers in response to the article:
He Declared War On Heart Attacks
Dr. Raymond Bahr
St. Agnes HealthCare
900 Canton Ave. Box RD
Baltimore, MD 21229-5299
Dear Dr. Bahr:
Thank You, Thank You, Thank You!
Because I read "He Declared War on Heart Attacks" in the
February Issue of Reader's Digest, I was able to recognize my best
friend's symptoms as heart related. His left arm has been bothering
him when he walked more than a block. He passed an EKG and treadmill
test with excellent results on paper. His left arm bothered him after
9 minutes on the treadmill. We made an appointment for a more extensive
evaluation at our Heart Institute. The day before his appointment,
he woke up with a neck ache and his left arm felt asleep. He called
to ask the cardiologist's nurse if he should come in now, she said
"No, it is a pinched nerve bothering you." One of the warning
signs in the article was discomfort in the left inner arm. I insisted
we go to check it out, and I insisted that I drive (also in the article).
We didn't come back home for 3 days. He had an immediate Angioplasty
and stent put in. His anterior descending artery had total blockage.
Blood tests the following morning showed some heart damage. (Feb.
24).
His symptoms were slight, but his problem was big. (59 years)
I believe, with all of my heart, that you and Carol Krucoff saved
his life.
Please send me more information.
I would really like a booklet on EHAC and information on how I could
get your audiotape and video. I have a great desire to learn more.
God Bless You For not giving up.
Shirley A. Loucks
N. 5111 Oak St.
Spokane, WA 99205
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Richard J. Maillett
330 East State Street
Doylestown, PA 18901
March 6, 1997
Dr. Raymond Bahr,
St Agnes HealthCare,
900 Canton Ave.,
Box RD,
Baltimore, Md. 21229-5299
Dear Dr. Bahr,
I would like to thank you for the recent article which appeared in Readers Digest February, 1997. For me it was a life saver.
I read the article in late January and on the night of January 31st, I awoke with some discomfort in my upper arms. Not thinking too much of it, I arose to have a glass of juice and wait for it to pass. While sitting, I experienced some "discomfort" in my chest. Since I was feeling sleepy, I decided to return to bed. When I was back in bed I noticed that my hands and feet felt sweaty and clammy. I then thought of the article which I had recently read, woke my wife and said that I thought that we ought to go to the emergency room. Although I felt "'fine" soon after arrival, the ER doctor did several EKG's over the next few hours and decided that I should be admitted. I was scheduled for a catheritization on Monday morning. The results were immediately apparent and I was whisked off to Presbyterian Medical Center in Philadelphia where I underwent triple bypass surgery a few hours later.
Everything went well and I was released in 4 days. I am now recuperating at home and hope to return to work, soon. Needless to say, this 63 year old will be eternally grateful to you and your educational efforts. Keep up the good work.
Sincerely,
Richard J. Maillett
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January 16, 1997
Dr. Bahr,
I just read the Article, "He declared War on Heart Attacks", in the February issue of Readers Digest. How very informing it was, and at the same time, how late the information became available to my family's attention.
Just one month ago, on December 17, 1996, I lost my Father to a heart attack at age 49, in the early morning hours, to which we thought, there were no prior indications.
How very wrong we were. He had the symptoms noted in the article just 5 days prior, and for approximately 90 minutes before the massive heart attack took his life.
He himself must not have known the symptoms. The Thursday before,
he complained of heart burn and an upset stomach, took some tums,
laid down for a while, and woke up feeling fine. On the morning he
died, he woke my mother up at 2:50 am, asked her for more tums, and
said he wasn't feeling well, and was going to go downstairs for a
while, but before he left the room, he turned to my Mother and said
he felt the same way he did last Thursday, and he had been awake since
about 1:15 am. and added that his chest felt tight. We had all been
sick with chest colds, so Mom was going to give him a few minutes,
then check on him. Less than a minute later, she heard him vomiting,
then heard him collapse.
Immediately, Mom ran downstairs, found him on the floor, and called
911. But it was too late. The doctors said he died instantly.
My Dad was an avid reader of Readers Digest, reading every issue
front to back. I wish this article had been in November or even December's
issue. He might have read the warning signs, and taken action. It
might have saved his life.
I can only pray that the information provided in the article gets
more attention.
Please continue your efforts on bringing this important information
to everyone's attention, and letting them know how serious
the "early symptoms" can be.
Due to your work and efforts, for each life that can be saved, and
each family spared from the sudden loss we have suffered, I COMMEND
YOU!
In Loving Memory of Donald E. Anderson.
Sincerely,
Sonya Peterson
5400 Hwy 6 N
Deerwood, MN 56444
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Linda L. Warner
932 NE 7th St.
Ocala, FL 34470
6/17/98
Dr. Raymond Bahr
St. Agnes HealthCare
900 Canton Ave.
Box RD
Baltimore, MD 21229-5299
Dear Dr. Bahr
I am writing in regard to the article that appeared in Reader's Digest
last year. It was entitled: He Declared War on Heart Attacks. I just
wanted to let you know that it saved my husband's life.
I had read the article and discussed it with my husband when it first
came out. We had both read such articles in the past, but it really
hit home because it stressed the importance of what is done within
that first hour and ended by charging others to be responsible for
those too stubborn or embarrassed to heed the warning signs. My husband's
father had had several heart attacks and had considerable damage done
to the heart because he did not seek help immediately. My husband
and I agreed that it would be better to feel silly than to be dead.
The article came out in the February edition. On May 1, my husband
called me at work to ask if we had any aspirins in the house. Now,
the important thing to know here is that I am a teacher, and my husband
NEVER calls me at work. I became immediately suspicious and asked
him why he needed them. He said that he had been having indigestion
all morning and now was having terrible discomfort in his chest. I
told him to call 911 and said I was on my way home.
I grabbed two aspirins from our school nurse (I have a hiatal hernia
and never have aspirins in the house) and ran to my car. I drove the
three longest miles home, and when I got there I grabbed a glass of
water as I came in through the kitchen and gave my husband the aspirins
while asking him if he had called 911. Of course, he said no. He just
had indigestion. I asked him if he could walk. He said yes. I told
him he could either go with me to the hospital or I would call 911,
and he could pay for the ride. He agreed to go with me.
I rushed him to the hospital, and we were immediately taken into
the emergency room. He was hooked up to a monitor and had been there
no more than 10 minutes when the nurse told him his EKG looked good
and his blood pressure was fine. I turned to fill out insurance papers,
heard a terrible sound as if someone was having a seizure and turned
back around to find my husband going into cardiac arrest. The emergency
team immediately set to work and within 10 minutes I was visiting
with my husband who was joking with the doctor and was about to go
up for a heart catheterization.
The catheterization showed a blockage of the main artery going into
the left side of the heart. The doctor performed angioplasty and said
my husband was very lucky to be alive. He said that giving my husband
the aspirin had given him an edge. He also said heart damage was so
minimal it could not be detected. How lucky we both were that the
article had reached us.
Somehow your personal experience of having lost a friend hit home.
And your crusade to prevent such losses gave me the nudge to ignore
my husband's pleas that he would be fine once the indigestion went
away. I am also sure that my story is not a lone one. Thank you so
much, and keep preaching your message.
Sincerely
Linda Warner
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September 1992 Article in Reader's Digest
What a Heart Attack Taught Me
by Jim Lehrer
At four that December morning, I woke up with a dry tightness in
my chest. My wife Kate, and I had been to a Mexican restaurant near
our home in Washington, D.C., and sometimes the enchilada and beans
exact a price. I woke Kate up and got out of bed. I drank several
glasses of water. Surely that would do the trick. "Let's call a doctor,"
said Kate. "No, no" said I. "It'll be fine in a minute." I got back
in bed. The tightness did not disappear. Eventually I dozed off, but
before long was awake again. Kate said to call a doctor. Once more
I said no. It had not gotten any worse. (Where I got that stupidly
incorrect information I have no idea.) Later that day, December 11,
1983, I had a Bloody Mary and a plate of food and made a small talk
at a holiday brunch. My chest was still tight. Was that a tingling
in my left arm? Isn't that a symptom of a heart attack? That evening,
Kate and I went out to dinner. She insisted that we go to a hospital
or at least call my doctor. I insisted that any minute everything
was going to be all right. No hospitals. Bad things happened to Lehrers
in hospitals. They died. Back home, I took a sleeping pill and went
to bed, but remained wide awake. At midnight, I finally got scared.
Indigestion should not last this long. Rolling Truck. Kate
phoned the doctor and described my symptoms. I was told to go quickly
to the nearest hospital. I insisted on driving. I also insisted on
smoking. I had a feeling my 30 years as an avid smoker might soon
be over, one way or another. I was determined to go down and out with
some tobacco smoke in my lungs. In the emergency room, a nurse put
me on an EKG machine. It revealed nothing, but because the chest and
arm problems persisted, the doctor sent me to intensive care. I was
given something to sleep, and sleep I did. In the morning, the tightness
and tingling were gone. I had no idea why. Nor did anybody else. Tests
were being run. I went to sleep that night with no trouble. But just
after 5 am, I awoke with something crushing down on my chest. It had
the weight and ferocity of a truck. My left arm was throbbing with
pain, as if a knife were slicing through it. I grabbed my arm and
doubled over. A nurse stuck something in my left arm, and another
forced something under my tongue. The truck kept rolling over my chest,
and the knife continued to slice. I moaned and rocked. Sweat poured
across my face. I wanted to scream. I wanted to cry. The nurses kept
mopping my face and talking to me. And then it was over. The truck
drove away; the knife disappeared. I lay back down on the bed.
"You made it", said one of the nurses. Made what? "You just had
a heart attack."
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Family Voices
Emotional Roadblocks, Misconceptions, Keep One Patient from Seeking Care
Janet Perrella-D'Alesandro
When my husband suffered a heart attack 3 years ago, fear and denial
won a battle with common sense and led us to delay treatment over
18 hours, with heart damaging results.
Dan was 36 at the time. While visiting relatives in neighboring Pennsylvania,
he felt what he thought was heartburn and went alone to an upstairs
bathroom. I found him about 45 minutes later vomiting and sweating.
Aided by a lack of basic knowledge about acute myocardial infarction
(AMI), we concocted an "it can't happen to us" scenario. In retrospect,
we were a classic case of denial/resistance/spousal enabling.
Fears vs. Facts
Although Dan was young, physically fit, a non-smoker, and had tested
negative on a stress test, the so-called "elephant" in the room we
chose to downplay was a strong family history. His father and four
uncles had all suffered from heart disease and died after multiple
heart attacks and bypass surgeries. Even more significantly, Dan's
sister, at age 35, had also suffered a heart attack 2 years before
his.
Dan refused a call to 911, saying that his symptoms were purely gastric,
not cardiac. I checked his pulse rate, which was slow and steady,
and ended up agreeing with him that this was probably a stomach virus.
After Dan's symptoms receded slightly, we drove home to New Jersey.
He had a restless night, punctuated by intermittent chest pain, but
he was still attributing his symptoms to the flu.
It was not until the next morning when I went to work and described
what happened to a co-worker that I realized the life-threatening
nature of Dan's symptoms. My co-worker, who was studying to be an
RN, said she had been on a cardiac rotation and had observed that
"heart attacks seem to follow no set pattern."
Her words jolted me out of my denial. I left my office immediately
and brought Dan to the local community hospital. An EKG and elevated
blood enzyme levels showed that he had indeed suffered an AMI, and
given that 18 hours had passed, had lost his opportunity to receive
tissue plasminogen activator (TPA). Heparin was administered, and
he was stabilized and transported to Thomas Jefferson University Hospital
in Philadelphia.
A catheterization revealed a clot in the left anterior descending
artery and "significant" muscle damage to the front third of his heart.
He had also formed a large clot in the right ventricle.
Because the damage in the affected portion of his heart was irreparable,
Dan did not receive an angioplasty. The rest of his heart appeared
healthy. He was put on coumadin (later replaced by aspirin), a beta
blocker, and an angiotension converting enzyme inhibitor and was sent
home to recuperate.
Preconceived Notions
I do not find it shocking that, as mentioned in the preceding article
by Christine Crumlish and Mary Hand, many people do not understand
the basic signs and symptoms of AMI.
After Dan's heart attack, I spoke with family, friends, neighbors,
and co-workers and discovered the power of preconceived notions (perhaps
fueled by television and movies) about cardiac arrest. I also realized
that my own expectations had played a major role in my yielding to
Dan's wish not to be taken to the hospital: I thought heart attacks
happened quickly and dramatically. Another misconception that led
me to dismiss a cardiac event was Dan's slow steady heartbeat - perfect
testament of how crucial it is to tell patients not to self-diagnose.
I also found that many people didn't know heart attacks can so clearly
mimic a flu, or that nausea, sweating, and vomiting are common symptoms.
"Normal" Tests
Along with our lack of knowledge, we had also been lulled into thinking
Dan had escaped his family history. Following his sister's heart attack,
he had been thoroughly tested and had normal results on his stress
test and EKG. His cholesterol was 200 mg/dI and his blood pressure
130/95.
Later blood work did show that Dan had an elevated level of lipoprotein(a)
[Lp(a)], 133 mg/dI, compared to the normal level of less than 35 mg/dI.
Lp(a) is a genetic variation of plasma LDL, and although its physiologic
functions are not fully understood, there is a positive association
of plasma Lp(a) with premature myocardial infarction.
Addressing the Psychosocial Issues
Also speaking volumes to the strength of the psychological walls
patients can erect is that, even with a prior history of AMI, coronary
heart disease, angina, or congestive heart failure, delay times do
not decrease. It seems that even a life-threatening shock is often
not enough to get people to act quickly.
Despite the potency of psychological defense mechanisms, there are
effective methods nurses can use when counseling patients:
- Speak to the emotional component first. After a heart attack,
patients and family members are lost in a whirlwind of emotions
- shock, fear, quality of life concerns. They may not be able to
hear crucial educational information over their own emotional noise.
The most reassuring words a nurse can use is to tell the patient
that all their feelings are normal. When counseling high-risk patients
about what to do in the future if faced with a possible AMI, tell
them that it is normal to want to deny or ignore the symptoms. I
also think they need to hear that it is normal to feel afraid or
embarrassed to be taken away in an ambulance.
- Give them a real-life example. People relate to real stories
about real people. Someone told me recently about a 53-year-old
man who felt chest pain and immediately told his wife to call an
ambulance. Because this man had never reacted with such urgency
about a physical symptom before, his wife knew something serious
was going on and called an ambulance immediately. The patient was
indeed about to have a heart attack, which was averted by treatment.
- Suggest that they throw away the "Hollywood" concept of a heart
attack. As my co-worker said, "heart attacks follow no set pattern."
Women, most of whom do not experience the "classic" symptoms of
chest pain, may especially need to hear this. Remind them that Olympic
athletes, famous long-distance runners, and many other unlikely
victims, have suffered heart attacks. Stereotypes don't apply.
Caregivers or spouses should also be told that they must be very
assertive if a patient is resisting treatment and that it is crucial
they don't let the person talk them out of their concern. They can
quickly identify the patient's most critical concern and address it.
They should be told to expect denial and reluctance, but not to let
this dissuade them from taking charge and getting the person to the
hospital immediately (Bahr, 1996-97).
Once patients and caregivers have been reassured about the emotional
issues and have begun to shed some of their preconceived notions,
nurses can begin educating them (see Table 2, page 80).
The Red Flag-Recognizing Early Warning Symptoms
Early warning signals of heart attack have been highlighted in public
information campaigns such as the Early Heart Attack Care (EHAC program
conducted by Raymond D. Bahr, MD, FACP, of St. Agnes HealthCare In
Baltimore, MD. According to Bahr, 50% of patients with heart attacks
have prodromal (early) symptoms. These symptoms can be specific or
non-specific. Non-specific heart attack symptoms Include weakness,
sweating, nausea, and dizziness. Specific symptoms (prodromal angina)
include chest discomfort, chest pressure, chest ache, chest burning,
and chest fullness.
One major reason patients do not come immediately to the hospital
is because these early symptoms occur intermittently, over hours and
sometimes days, leading the patient to believe that they may go away
(Bahr, 1996-97). (The early warning symptoms applied directly to Dan.
He had been experiencing what he thought was heartburn for 2 weeks
and he treated himself with an over-the-counter antacid.)
Chest Pain Centers
Along with the EHAC information campaign, Dr. Bahr has also spearheaded
the creation and promotion of chest pain centers (CPC in hospitals
nationwide. These centers are designed to fast track patients with
AMI.
The centers have observation areas for patients with acute myocardial
ischemia and are staffed by critical care nurses and physicians who
undergo continuous retraining for heart attack management. Tests at
chest pain centers include enzymes (CPK/MB, myoglobin, and troponin),
ST monitoring, technetium sestamibi, nuclear testing, echo, and stress
tests. CPCs also have detection programs to target and educate high-risk
patients and educational outreach programs. (Early Heart Attack Care
[EHAC] Awareness, 1997).
There are currently 1,200 chest pain centers in the United States
with ongoing efforts by Dr. Bahr to have them in every emergency room
in the country by the year 2000 (Krucoff, 1997). Because these centers
are designed to help people experiencing any type of chest discomfort,
patients may be less intimidated or embarrassed about seeking treatment.
Encouraging Self-Education
Along with giving educational materials to patients and caregivers
(see Figure 1, page 86), nurses should encourage them to become as
familiar as possible with cardiac risk factors, symptoms, and treatments
on their own. Dr. Bahr's EHAC program has provided free videotapes
for rental at all Blockbuster Video stores nationwide. In addition
to the NHAAP page on the NHLBI Web site, (www.nhlbi.nih.gov/nhlbi/othcomp/opec/nhaap/
nhaapage.htm), nurses and patients may access the EHAC site at www.ehac.org
(the site provides a phone number to call for the location of the
chest pain centers In the U.S.), e-mail: info@ehac.org; or the American
Heart Association main page at www.americanheart.org/.
Conclusion
My personal story has a happy ending. Since his heart attack, Dan
has been very proactive in his care. He follows a very low-fat, vegetarian,
high-fiber diet, and he exercises regularly. Our "time is muscle"
lesson was well learned after his first heart attack and we now respond
to symptoms by immediately going to the hospital. Although the artery
to the front wall of Dan's heart remains blocked, new blood vessels
(collaterals) have grown to take over circulation in this area, boosting
overall function. Last year, to combat a new blockage, a stent was
placed in the left circumflex coronary artery. Thanks to that technology
and his lifestyle changes, Dan continues to enjoy his three children
and leads an active, and certainly more heart-aware, life.
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PAULETTE B. BROWN
27631 MAPLE VALLEY DR.
ELKHART, IN 46517
1/28/97
DR. RAYMOND BAHR
ST. AGNES HEALTHCARE
900 CANTON AVE.
BOXRD
BALTIMORE, MD 21229-5299
DEAR DR. BAHR:
JUST THIS PAST WEEKEND I RECEIVED MY LATEST COPY OF THE READERS DIGEST WITH THE ARTICLE BY CAROL KRUCOFF ABOUT YOUR VERY TIMELY AND INSIGHTFUL HEART ATTACK TREATMENTS. IT JUST SO HAPPENS THAT MY HUSBAND RECENTLY SUFFERED A "MILD" HEART ATTACK, IF THERE IS SUCH A THING. HE DID HAVE THE SYMPTOMS OF DISCOMFORT IN THE TEETH, JAW, INNER ARM AND BACK. WHAT HE THOUGHT WERE SEVERE MUSCLE SPASMS TURNED OUT TO BE A HEART ATTACK. HE LET THOSE SO-CALLED MUSCLE SPASMS GO ON FOR A FEW DAYS UNTIL HE COULD NO LONGER ENDURE THE PAIN. IT WAS THEN THAT I INSISTED THAT HE GO TO AN EMERGENCY FACILITY TO BE CHECKED. THANK THE LORD FOR A VERY CAPABLE DOCTOR THERE WHO DID NOT LIKE THE LOOKS OF HIS EKG AND FAXED IT TO A CARDIOLOGIST THAT VERY EVENING. AFTER ANOTHER EGK AND AN ECOCARDIOGRAM, SCAR TISSUE DID SHOW UP ON THE BACK OF HIS HEART AND LUCKILY THERE IS NO BLOCKAGE IN HIS VALVES OR ELSEWHERE. NEEDLESS TO SAY HE WAS VERY LUCKY THIS TIME. I HAVE POSTED THE SYMPTOMS IN MY PLACE OF WORK AND WILL PASS THEM ON TO OTHER MEMBERS OF OUR FAMILY. HE HAS HAD A FOLLOW-UP APPOINTMENT WITH A CARDIOLOGIST WITH MORE TESTS, I'M SURE, TO BE RUN IN THE NEAR FUTURE. HE LUCKED OUT THIS TIME, BUT WHO KNOWS WHAT MAY HAPPEN LATER.
I AM REQUESTING THE FREE VIDEO, AUDIOTAPE AND BOOKLET ON EHAC. I ALSO WOULD LIKE TO KNOW ABOUT ANY HOSPITAL IN OUR AREA THAT HAS A CHEST PAIN CENTER. THANK YOU FOR YOUR GIFT OF KNOWLEDGE AND FOR CARING SO MUCH.
SINCERELY,
PAULETTE B. BROWN
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This card was designed by a child who is a cancer patient at
The University of Texas .D. Anderson Cancer Center
March 30, 1997
Dear Dr. Bahr -
Two months ago my husband had a heart attack. We both feel that he is alive and well today because of the article about you and the early warning symptoms which was in Reader's Digest. When the symptoms began, he did not hesitate to get to the emergency room of our nearest hospital, where he received excellent treatment. What a timely article! If it had not been for that, he admits that he would have waited until a convenient time to check with his doctor. You see his attack came at midnight on a Saturday night. Thanks! Thanks for your
Hugs -
Glenda Minnie
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Amir H. Kazory, M.D.
No. 31 15th St.
Chehel Sotun St.
AsadabadiAve.
14318-Tehran
IRAN
Dr. Raymond Bahr
St. Agnes Health Care
Baltimore, Md.
April 12, 1997
Dear
Dr. Bahr;
I am writing this letter to congratulate you on your success in fighting the old beliefs and thoughts surrounding the basic concepts of heart attack. Your attempts seem to me so wonderful and extraordinary and I was really shocked by what I read in Reader's Digest about you. In fact, it may now seem to you so late but this is the first time that I become aware of this news. I believe this is truly the same way every young physician, like me, should follow.
I am a 28-year old assistant of cardiology in Tehran medical school, highly interested in reading and writing simplified medical articles. I have also been a translator of such articles since the first years of medical school. Unfortunately, I had not heard of EHAC before reading the article in Reader's Digest, and I strongly believe that so many practitioners in Iran know little about it either.
Therefore, I am going to translate this article into Persian in order to introduce you and your works to the people of my country. I will be so grateful should you kindly send me a video/audio tape and booklet on EHAC in addition to any other information which, you believe, will help to introduce your works more effectively.
I am looking forward to hearing from you soon.
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January 25, 1996
Dear Dr. Bahr,
My 40 year old husband died of a heart attack in the emergency room of our local hospital just over a year ago. How I wish our ER had known of the EHAC program! Perhaps they could begin to learn now!
Would you please send me the video, audiotape and booklet referred to in the February 1997 Reader's Digest article? I would appreciate any other information, statistics, etc. you would care to include.
Most sincerely,
Jeanna Jolley
1502 Farrell Lane
Richland, Wa 99352
(509) 943-1987
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February 18, 1997
Dr.Raymond Bahr
St. Agnes Health Care
900 Canton Ave.
Box RD
Baltimore, MD 21229-5299
Re: "He Declared War on Heart Attacks"
Readers Digest - February, 1997
Dear Dr. Bahr:
Thank you! Thank you! Thank you!
About a week after I read the above article, my husband suffered a heart attack. He just turned 47 in January. Although it turned out to be a minor attack, it was pretty scary. I immediately recognized his symptoms as they were exactly what was described in "Warning Signs of a Heart Attack:" chest discomfort (he later said it was never really what you could call a "pain"), sweating, and shortness of breath.
I remembered the part about taking an aspirin, which I had him do, and then we were off to the emergency room. The EKG indicated a heart attack in progress.
With some major lifestyle changes, quitting smoking, exercise, and eating better, we're hopeful things will improve. The small vessel that caused the heart attack was destroyed, but the angiogram indicated 50-60% blockage in another major artery. He returns to the hospital in a couple weeks for a stress test. We're keeping our fingers crossed that angioplasty will not be necessary.
I just want you to know how much I appreciate your continued efforts to spread the word about the early warning signs of heart attacks. That information helped prevent my husband from suffering unnecessary additional damage to his heart because we realized what was happening so quickly.
Sincerely yours,'
Paula DuBois
1301 W. 2nd Ave.
Devils Lake, ND 58301
cc: Reader's Digest
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Subject: Early Heart Attack Care
Date: Fri. 29 Aug 1997 M0157 -0500
To: 11 - (052)1nfo(a)ehac.org"
Dr. Bahr;
I just read the article about you in the Feb. 97 Readers' Digest. FYI, to add to your store of things to look for in the early stages of problems, I offer the following:
My husband had the crushing chest pain for the second night in a row (he had not woken me the first night), but this night the pain was radiating down to both hands and he was wild-eyed and gray and he woke me to ask if he could be having refluxing pain. I rushed him to ER here in Panama City FL. Luckily his doctor worked aggressively - within 35 minutes he was in ICU and being treated. Catherization showed 3 major blockages, 95, 85 and 70 percents. He had a triple angioplasty with stents in all 3. After the cath, he was given oxygen due to his condition - after -20 minutes, as color came into his face, I realized how gray/yellowish brown had been looking for such a long time. Years ago his complexion had been red-cheeked - I thought he'd gotten that look from working too much and not getting out fishing etc. enough. But, it was just from reduced oxygen! Then in hindsight, I believe that the severe difficulties he'd had with the flu just 6 weeks prior may also have been associated with the heart condition - he was so ill I've never in 27 years seen a 'flu' hit him like this. He missed 2 complete weeks of work and took a LONG time to feel much better. His symptoms then that I believe are related, were 1) he had TERRIBLE night sweats. He's had the flu often enough in the years I've known him, but I've never seen this in him he'd wake up as often as 6 to 10 times a night - for about 7 days so drenched that he'd have to chance sheets, night clothes, and the beach towels he'd laid down to absorb most of the sweat. 2) He had real difficulty staying asleep; at -first I thought it was just because of the night sweats, but now I'm not so sure. 3) His snoring - which had gotten quite loud over the past year prior, became horrendous. I had a doctor appointment the day after my husband was hospitalized, with my ENT - I mentioned my husband's condition and he asked, "has he been snoring really loud and chokingly for a while now?" I said yes. My doctor said that was not true snoring, it was a struggle for oxygen! And, it must have been - because now that my husband's condition is 'repaired', he hardly snores at all! I'd like to know your thoughts on these items.
I was really enthralled to read the article about how you persevered -you've surely saved the lives of many people. I was able to recognize the problem in my husband - and insist on the ER immediately - JUST because of articles similar to yours in which the emphasis is on treatment NOW, never mind the 'embarrassment', etc. if I hadn't read those articles, I, too, would have believed it to be transitory or perhaps GERD (like I have and I've thought I was having a heart attack when it woke me up at night, too), and my husband might be dead now. Please keep up the attack - people need doctors like you.
Now I have a couple of questions, if you could help:
1) What is the difference between someone having what is referred to as a 'heart attack', and someone like my husband who had all the symptoms but no heart damage? Is his just angina because there was no heart damage? Are the physical symptoms the same but one is more severe and causes the damage? How can WE, at home and at night, tell the difference?
2) I edit a newsletter where I work - I recently ran an article from the Am. Heart Assoc. about heart attack symptoms/treatment, etc., but your information is even stronger - do you have information I can include in a future issue? Your early warning signs are somewhat different from theirs, and, as I evidenced in my husband, he WAS having some of the signs you list that the AHA doesn't. So I believe your information might be critical. I'd like to order that free video, audio and booklet, and do I have permission to share it with my company's readers? I'll be happy to send a donation for the materials if you tell me where and what to send.
3) I have read about the 'crease in the earlobe' being an early indicator of potential problems - and, in fact, my husband had them and they are now not so prominent. I, too have them, but I'm not sure mine are not from wearing pierced earrings that drag the ear - like so many women have. Your opinion? What causes the crease and how is it related to heart trouble, blockages, whatever?
Send packet to:
Ilona Ryals (PERSONAL)
c/o Arizona Chemical Company
12 Everitt Avenue
Panama City FL 32401
I deeply appreciate your reply. May God Bless you and your family!
Ilona Ryals
At Internet Address: Ilona.Ryals@IPaper.com
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Kathleen A. Shanks
6 Brooks Road
Bel Air, Maryland 21014
February 16, 1997
Dr. Raymond Bahr
St. Agnes HealthCare
900 Caton Avenue, Box RD
Baltimore, Maryland 21229-5299
Dear Dr. Bahr,
Thank you for your tireless work and refusal to quit. The February 1997, article in Reader's Digest really touched home. My husband is now permanently disabled from a 1986 AMI for which symptoms were not realized as such and therefore ignored. The fact that he is still alive today leads me to believe that he would have suffered only minor heart damage had I or the hospital who received him known and acted on the "Golden Hour'.
I am a Security Officer at the University of MD Medical System where I have seen first hand how well the Chest Pain Evaluation Center works. But more importantly, I am now a CPR instructor for the AHA, the Red Cross and the National Safety Council. Our 17-year-old son is also a CPR instructor. We want to help share your work with those we instruct. The current lesson plans are excellent, but anything we can add to bring the message home is a plus.
We would very much like the video, audiotape and booklet on EHAC. The article wasn't clear on how much postage would be necessary. Please let me know via the envelope enclosed or a phone call: work at UMMS: 410-328-1329 Monday through Friday; home: 410838-1780 (anytime).
Sincerely,
Kathleen A. Shanks
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1/27/97
Dr. Raymond Bahr -
I am writing in response to your article in the Reader's Digest this month.
My mother died suddenly on Oct. 10, 1994 of a massive heart attack at the age of 44. She had all, or most, of the symptoms listed and drove herself to the hospital in our small rural town. (This was around 6:30AM on 10/10/94.) They told her that it was musculoskeletal pain, gave her some pain medication, and sent her home! She hurt all day, but felt sure that it would subside, since it was only "musculoskeletal pain". She died at 9:30PM as I was talking to her on the telephone!
Our hospital has absolutely no knowledge on cardiac problems or chest pain in general. They don't even carry a defibrillator on the ambulance, unless the person calling them asks them to bring one. I see people of all ages dying of heart attacks down here and it really bothers me. Our closest hospital that pays special attention to "chest pain" is in Paris, TX (50 miles from us).
If you could send some information, I would greatly appreciate it. If I could save just one of these "uncalled for" deaths, I know my mom would be smiling down on me from heaven. I really appreciate what you're doing and the article was very reassuring for me.
Sincerely -
Julie Deaton
(405) 298-6318
P.O. Box 819
Antlers, OK 74523
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Jan. 23, 1997
Dr. Raymond Bahr
St. Agnes HealthCare
900 Canton Avenue, Box RD
Baltimore MI) 21229-5299
Dear Dr. Bahr:
My father died in 1959 at age 45 with symptoms exactly like those you described in the Reader's Digest article: strong intermittent pain, which he ascribed to indigestion. By the time he went to the hospital at 5 the next morning, the damage was done. He lived for another two weeks, then died from another heart attack the day he was due to come home. I don't think they knew how to treat the heart attack, even after it was identified.
Since I'm married to a high-powered, individual just like my dad, in another high-stress profession, I'm very interested in what you have to say. Please send any available information to me.
Thanks,
Sylvia Phelps
15303 Friends Street
Pacific Palisades CA 90272
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 Feb. 1, 1997
Dr. Raymond Bahr
St. Agnes Health Care
900 Canton Ave.
Box RD
Baltimore, MD 21229-5299
Dear Sir,
I read your article in February 1997 Reader's Digest and thought the story was wonderful on the work and research you are doing on the warning signs of a heart attack. My dad died at the age of 56 of a heart attack. At the same time he thought it was indigestion. But two hours later he died at home, also not wanting to go to the hospital for "just indigestion".
Enclosed is a self-addressed, stamped envelope for a chest pain center and any other information you have on EHAC.
Thank you,
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| Albert H Flynn
17921 Holly Brook Dr.
Tampa, Florida 33647
Home Phone 813-9734955
February 01, 1997
Dr. Raymond Bahr
St.Agnes HealthCare
900 Canton Ave.
Box RD
Baltimore, Maryland 21229-5299
Dear Dr Bahr,
After reading the February issue of the Readers Digest I was very impressed with you and your work and wanted to write to you and express my appreciation for everything that you have done for people that you do not know.Your life should be an example for young people to strive for the best. You are the role model that young people should look up to. Hard work and the desire to help others leads many people to very rewarding careers. We, the Arnerican people are deeply indebted to you and I hope that each and every day you receive the thanks of the people you are helping.
You have worked hard all of your life. My hope for you is that you have taken a little time to" smell the roses".
Thank you for being a Doctor of extraordinary skills and determination to make a difference in this world. My prayers go out to you for good health and continued success.
Sincerely,
Albert H Flynn
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January 27, 1997
Dear Dr. Bahr,
On June 1, 1996 my father was doing some light work in our yard it was nothing out of the ordinary that week, because my father was trying to fix everything in such a short period of time as though he would never get another chance to due so. My mother was very worried that week because my father always predicted that he would suffer a heart attack sometime in his life like his father did many years ago. My father never went to a Doctor as long as I am alive, and I was twenty years old when my father took a Massive Heart Attack in front of my family in our home. He always experienced tooth aches, head aches and even often chest aches, but never paid them any mind just awaited their departure. As he slowly walked in- our living room that awful day in June he fell to the ground as though he was so tired. We yelled at him for not just getting on the couch to rest but I then realized that as he fell to the floor he had no reflexes; that his knees did not hit the floor first or even his hands just his whole body. As he crawled to the couch, he continued to tell us not to make a fuss, that he was just a little dizzy as he always was. When I looked at my father's face that day he was such an odd shade of grey he was sweating so horribly and holding his jaw, again he led my family to believe it wasn't a heart attack because he would have had chest pain. The face my father had that day will stay with me all of my life, you see Doctor I always took time to look at my father and the man on the couch that day was not him. I then screamed for my oldest brother to call 911 and let them know he was having some sort of a attack. When the emergency unit arrived they brought my father to the nearest Hospital where they told us he was in the middle stage of a heart attack and that he would be going to Jefferson Hospital to under go Angioplasty. The doctor's let us know that it was not looking good for my father at all and that they would do everything they could to keep my father on this earth. Hours later that seemed like days, my father came through wonderfully when we approached the doctors to thank them for everything, they told us that they were not responsible for helping my father that someone in heaven had been watching over my father because his entire right side of his heart had shut down and he should not have made it. It has been 7 months and with my fathers great new eating habits and no more chain smoking, my father is alive and well. I read your story in February's Issue of Readers Digest and I was fascinated with all that you have accomplished and how important of a drive you have to never let go of your dreams. The Chest Pain Center was a unbelievable idea and it is because of people like you that I have my father to watch me chase my dreams. Thank you Dr. Raymond Bahr, so much.
I never realized how much my father's heart attack effected me until now. I am 21 years old I still jump up every time my father gets a pain somewhere and I am glad that you can give me the chance to know it's O.k. to be this way.
Sincerely,
Marietta Casillo
(Philadelphia, Pa.)
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1-24-97
Dear Dr. Bahr,
I just finished reading your article in Readers Digest, and I want you know how much I agree with you. I'm an RN in our small community hospital, where we care for a wide range of patients - ER, OB, ICU, elderly, etc. I've seen many patients like you described, but it became very personal to me, when my mom had a heart attack Aug. 26, 1996. She always watches her diet, walked 2 to 3 miles daily, not overweight - in great shape for age 70. I had talked to her several days earlier, because she never mentioned that she had had mild chest pains with exertion, and the pain usually worse in the center of her back, abdominal nausea, dippnea, fullness in the throat, because it went away. But on Sat. morning while cleaning house, the pain and shortness of breath was enough to scare her and have dad bring her the 25 miles to our ER. About 4 miles from town she had a severe chest pain, dippnia - very diaphoretic. Dr. Dunn was on call; as soon as lab work, EKG etc. Was done, he started TPA, followed by heparin gtt. Within an hour we Life Watched her to St. Francis in Wichita, where they immediately did a catherization. It showed a 90% blockage in her right coronary artery. Angeoplasty was done the next morning. I talked later with her and dad about the early warning signs of heart attacks. They knew, but mom just felt like it was indigestion. She's doing great now, thank goodness.
I would like to receive your video, audiotape, and booklet to share with my brothers and sisters. We all need to be more aware, and no one can be too educated. Thank you.
Sue Rogers
706 West 12th
Scott City, KS 67871
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January 27, 1997
Dr. Raymond Bahr
St. Agnes Healthcare
900 Canton Avenue
Box RD
Baltimore, MD 21229-5299
Dear Dr. Bahr:
On December 5, 1996, my 47 year old fianceé was experiencing chest pain. I took him to a Medical Clinic near home, and his blood pressure was high, but his EKG was fine. So off to work we went. At about 2:30 pm the same day, he called me from a parking lot picking up supplies for his Contractor business. This time he had every symptom of a heart attack; vomiting, chest pain, numbness in the jaw and down both arms, and sweating. I left work and took him immediately to the Emergency room at Sacred Heart Hospital.
We were in the Emergency Room for four hours. The physicians on duty felt it was heartburn, prescribed Zantac and sent him home.
At 4:30 am December 6, 1996, my fianceé awoke with severe pain. Out of desperation and guidance from above, I dialed 911. The ambulance took him back to Sacred Heart Hospital and this time, he was diagnosed with a Heart Attack. He went into surgery immediately with Dr. Hawn, a heart surgeon. His right main coronary artery had collapsed. The angio plasty that was done also required a stent due to the artery not taking to the balloon method.
Frank is doing better these days, but I am continually wanting to further my knowledge on the heart and heart attacks.
After reading the article in February, 1997 Reader's Digest on you, I applaud your efforts! I would appreciate any information you can send us on EHAC. Again, I sincerely appreciate people like you, who through tireless efforts, are able to help fellow Americans live a healthier life.
Keep up the excellent work!
Sincerely,
Debe McQuillen and Frank Lewis
895 Territorial Street
Harrisburg, Oregon 97446
(541) 995-3768
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My sincere appreciation for your dedication in getting EHAC information to the public. I read the article 'in Reader's Digest last night and since my father, Thurman Griggs, is a subscriber, I found myself wishing that this had been published in the December issue.
On December l3th, he suffered a severe heart attack due to blockage that had been detected some time ago. I can only speculate as to why it wasn't dealt with before, perhaps his former Doctor believed the drugs he prescribed in 1995 had taken care of it,I do know that a stethoscope was the ONLY equipment used to diagnose him and follow the drugs effectiveness. But that is now history.
The article brought out what I feel was one of the most solid points to be addressed; "too stoic or embarrassed to seek help". As I stood beside my father in E.R., he kept repeating remarks of that nature. He related that he had been experiencing symptoms for several days and that only some minutes before the onslaught of vomiting, and chest pains, he had been describing the early warning signs to his neighbor. The neighbor, having suffered a heart attack several years ago, told him that he needed to "go on to the doctor and don't wait". My father had replied, "Well, I hate to, I have an appointment in a couple of weeks." With that last statement, he walked into his house and collapsed into a chair as he grabbed his chest.
Dad would also tell me later that he just didn't know "how much (symptoms) was too much" and that he hated to go to the doctor if it were just indigestion- Only a week before his actual attack I had been visiting and he had asked me to rub his back and complained of severe muscle pain in a certain area. I questioned him then; did he think it may be related to any heart problem? He brushed off my concern.
On December 13th, however, control over his life was taken from him when the driver of his ambulance pulled in to the tiny emergency room of a near-by hospital. They were in route to the "Chest Pain Center" in Jackson, Tennessee, but were forced by Dads condition to stop at the first available ER in order to stabilize him.
The emergency room technicians and ambulance personnel had obviously been trained in the areas that you have worked so diligently to promote. A "clot-buster" drug was administered and when blood pressure had improved, they continued on to the Jackson Center where he received immediate treatment. Local heart specialist, Dr. Tony Phillips, had been alerted and was standing by to order an angioplasty.
To make a long story short, after a twelve-day stay and the placement of a stint, my father was released and is on his way to recovery. I fully believe that the quick response and actions of the medical staff was crucial in his 0% damage of heart muscle, according to Dr. Phillips' findings.
This letter is but a small token towards giving credit due you, however, please know that countless patients and families remember you in their prayers of thanks. Your work has obviously had far reaching effects to reach even small town emergency rooms.
Please feel free to use this letter if in any way it can help to establish credence to your worthwhile fight to get this information to the public. Best wishes and I hope for your continued success.
Sincerely,
Sherrie L. Traweek
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January 24, 1997
To: Dr. Raymond Bahr
St. Agnes HealthCare
900 Canton Avenue, Box RD
Baltimore, MD 21229-5299
Dr. Bahr, I recently read the article entitled He Declared War on Heart Attacks in the February issue of Reader's Digest. I must tell you that I am grateful for the role you played in heightening awareness and providing early care for potential heart attack victims. My husband has been treated twice in chest pain centers here in Houston, has received TPA twice and has had excellent results. He was 39 when he had the first event and never expected that the pain he was experiencing could be a heart attack at that age. I never realized that a single person was instrumental in making this kind of care possible. I want to thank you personally for your persistence and concern. Thanks to you and people like you, my husband is alive today.
I would like to request that you send me a copy of the free video, audiotape and booklet on EHAC. Please find enclosed a self addressed stamped enveloped as requested in the article.
Sincerely,
Linda de Vega
7322 La Mesa
Houston, TX 77083
(281) 498-7175
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4918 Gerald
Warren, MI 48092
Jan. 30th, 1997
Dr. Raymond Bahr,
I read you story in the Reader's Digest, February 1997 issue. It brought back memories of the very thing you talked about. My husband didn't have severe pain either. While playing cards, he rubbed his hand across his chest and my daughter, a nurse, asked him if he was having pains in the chest. He told her it wasn't a pain, it was funny, fluttery feeling, but he looked sort of pale. Well, he ended up in the hospital and quadruple by-pass back in 1987.
I would appreciate your offer for a free video tape, audio tape and booklets. I will use it to show at my senior citizen club at church. God bless you for your persistence in your work. I'm sure you are being prayed for. I certainly will include you.
Mrs. Helen Sobieski
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