Monthly Archives: January 2015

Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life (excerpt #49)

Summer in the Waiting Room, , , , , ,
This image shows a healthy 98% oxygen saturation level (www.shutterstock.com.)
This image shows a healthy 98% oxygen saturation level
(www.shutterstock.com.)

Author’s note: The following passage is from Chapter 5, “Buen Corazón,” of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life.  This is the 49th excerpt in the series.

THERE ARE ONLY TWO MORE EXCERPTS LEFT!

The conclusion of Chapter 5 and the final excerpt in this blog series will post on February 11, 2015. The book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life, is scheduled to be published and available later this summer. Stay tuned!!

To catch up on what you missed, click on the image above to read ALL excerpts.

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On the morning of June 26th, two days after my transfer to the ICU, the cardiac team of doctors came into my room with encouraging news.  Although my heart was badly damaged by the June 7th heart attack, the complex concoction of heart, blood pressure, blood-thinning, cholesterol, and diuretic medicine appeared to be working.  The ejection fraction measurement of heart function was well-below the normal range, but stabilizing, and other organs, minus the lungs, were functioning well.

As a result, the cardiologists concluded, there wasn’t a need for a heart transplant, and once the lung issues were resolved, I could lead a slower, but somewhat normal life after the ICU. One of the cardiologists working on my case was a smart, petite, soft-spoken woman who was born and educated in India.  Her engaging smile and the optimistic look in her eyes exuded the seemingly conflicting qualities of confidence and humility which provided a sense of hope and comfort to me and Sandra.

As a self-proclaimed information hog, I peppered her with questions about heart function and the pros and cons of a heart transplant.  The doctor addressed each inquiry with patience and clarity.  Sandra and I later asked her if she was available to be my cardiologist, to which she readily accepted. Just as the cardiologist and her colleagues were summarizing their conclusions, I suddenly began having more difficulty breathing.

For the past few days, my oxygen saturation percentage had been hovering around the high 80s to low 90s, which wasn’t good, yet not alarming.  When oxygen levels dipped below 90%, the monitors emitted a high-pitched sound that beeped every second or so.  Immediately nurses and respiratory technicians would come into the room to determine if any adjustments were needed to the airflow.  My breathing became more labored by the minute and the high-pitched beep became a steady ring.

The cardiac team left to make room for a team of respiratory therapists and pulmonologists. Doctors struggled to understand what was causing the low oxygen levels for the next two days. Respiratory technicians replaced the high-flow tubes that sent oxygen through my nostrils with a non-breather mask that covered my nose and mouth to generate a more concentrated flow of oxygen into my lungs.

The clear mask uses elastic straps around the ears and head to keep it in place and a rubber strip around the edges to prevent patients from inhaling any room air.  When patients inhale, a valve opens up to allow 60-80% concentration of oxygen to be delivered. For about a day, the mask seemed to do the trick as my saturation levels stabilized in the low 90s.  Each movement of my body or a sudden cough would send oxygen levels plummeting into the 70s.

I remember breathing heavily trying to catch my breath and looking at the monitors to see my oxygen level at 73%.  I labored with each breath while doctors and nurses adjusted the inflow of air and drew blood to do more tests to find answers to my lung problems.  Pneumonia and infection were ruled out with each returning test result.  Although Sandra tried to maintain hope and faith, I could see concern and worry seeping into her face.

On the night of June 28th, the pulmonologist directed the nurse to remove the clear non-breather mask and place me on a Bi-Level Positive Air Pressure (BIPAP) machine to help me get through the night.  The BIPAP machine is a small bedside respiratory machine connected to tubing and a facemask that helps patients breathe by completely sealing off outside air.  It pushes air into the lungs and holds open the air sacs in the lungs to allow more oxygen to enter.

When the nurse strapped the facemask to my head, it felt like a very tight football helmet that covered my entire face and head.  With the mask in place, I felt isolated and scared as I could feel and hear the air rushing into my face with an echoing swishing sound. Suddenly panic began to set in and my mind swirled thinking about dying.

I was in a completely helpless situation. I couldn’t breathe. I had this contraption wrapped around my head and face. I had no control of anything at this point in my life. If death was my ultimate destiny that night, I thought, I hoped that it would come sooner than later.

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Next Wednesday: Oxygen saturation levels continue to plummet as doctors try to find a solution…

Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life (excerpt #48)

Summer in the Waiting Room, , , , , ,
Buen Corazón at home still watching over me.
Buen Corazón at home still watching over me.

Author’s note: The following passage is from Chapter 5, “Buen Corazón,” of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life.  This is the 48th excerpt in the series. Click on the image to read ALL excerpts.

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The next week in the coronary care unit was a blur for me. While cardiologists closely monitored my heart to determine a plan forward, pulmonologists remained concerned that my oxygen levels wouldn’t stay consistent fluctuating from a normal 97% to a dangerous mid-80%.

There was a steady flow of visitors: Marisa and Erica, the Peralta clan, my brothers David and Stevie, my sisters Barbara and Sisi, Rudy, Will, Melody, Juanita, and other family friends. I don’t recall much about what was said during that time, I just knew they were there and their presence gave me hope, comfort, and the courage to fight on.

One brief visit and conversation has stayed with me since that time. My college friend Damian Trujillo had stopped in to see how I was doing to find me connected to heart and oxygen monitors that were beeping and purring behind the bed. I was also connected to a high-flow oxygen system that delivered air through narrow tubes placed in the nostrils. The pulmonologists wanted accurate and ongoing oxygen saturation readings to ensure that my body was getting the oxygen it needed.

To get an accurate reading, the oxygen monitor was placed on my forehead kept in place by a headband.  I’ll never forget how the ball-shaped monitor hurt as it dug into my forehead.  Damian joked, “Míralo, you look all bad like a cholo with that headband.” That’s one of the few times I remember laughing during the ordeal. I later learned that he brought tamales to add to the growing stock of food in the waiting room.

In the cardiac ICU, I had a hard time sleeping and my anxiety increased as sedative medicine wore off.  Sandra stayed in the room with me each night only to lose sleep herself because I would be awake all night and sleep just a little during the day.  Bedridden and weak, I increasingly became frustrated.  My anxious mind conjured up worse case scenarios and I felt scared, especially when Sandra was out of the room.

Throughout our life together, she had been the solid foundation to my workaholic dream-building ambitions. Lying in a state of uncertainty while doctors tried to stabilize my heart and figure out what was wrong with my lungs, the loneliness and helplessness without Sandra sitting next to me was demoralizing.

Marisa and Erica would visit briefly to say good morning and good night.  Sandra wanted to make sure that their daily routine continued as the medical crisis entered its third week.  Without the sedatives, I started to understand the grave situation I was in and my spirits continued to dive.  The girls would come into the room with a smile and “hi daddy,” but I could see the sadness in their eyes.

One evening just before bedtime, they came in to say good night with a gift in hand, a Build-a-Bear in green surgical scrubs and hat. They named him Buen Corazon and sat him on the headboard to watch over me.  He held an X-ray of a healthy heart in his left paw.  They asked me to squeeze his right paw, and Marisa’s voice came out of him saying, “Get well soon daddy.  We love you!  Love Marisa and Erica.”  Sandra’s eyes welled up with tears, and with a huge lump in my throat, I held mine back.

At that moment, a range of emotions washed over me: unconditional love, sadness, fear, and a steely resolve.  I smiled, thanked the girls, and told them that I would be fine.  After hugs and kisses, they said good night and left the room as Sandra and I silently held hands.  With unconditional love for Sandra and the girls and Buen Corazon watching my back, I felt a sense of confidence that all would end well.

My heart, although seriously weak, stabilized after a few days in the CCU.  Nurses prepared me and all of the monitors for a quick ride to the ICU just down the hall so doctors could concentrate on my oxygen and lung issues.  That day, and the next three or four days, would be the clearest for me in some time.

Leaving the cardiac ICU, I high-fived nurses and staff as my bed rolled through the unit.  I got to know the people caring for me and made sure that I thanked them as I left, even if I was lying on a bed.  Once in the ICU, I was reconnected to the monitors and oxygen in the room that was to be my home for the better part of that summer.

In the ICU, my room was buzzing with activity.  Nurses walked in regularly to check on the growing forest of IV stands holding the various medications that were keeping me going and monitor the machines and gauges that were tracking my minute-by-minute progress. Watching the LED lights blinking and rising and falling on the monitors was like looking through a kaleidoscope filled with red, green, and orange glass.

Like clockwork, nurses came in to draw blood, add medication to the clear plastic bags hanging from the IV stands, and take my temperature.  Cardiologists, pulmonologists, and critical care physicians checked in three times a day to report on my condition.  It was an intense experience, but it was clear that the doctors, nurses, and staff were working hard to help me get better.

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Next Wednesday: After a couple of days of progress, my oxygen levels suddenly plummeted as I struggled to breathe…

Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life (excerpt #47)

Summer in the Waiting Room, , , , ,

 

Patient on ventilator -image does not reflect actual events - Image by www.heart-valve-surgery.com (click on image to read all excerpts)
Image does not reflect actual events – Image by http://www.heart-valve-surgery.com 

Author’s note: The following passage is from the manuscript of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life.  This is the 47th excerpt in the series. Click on the image to read ALL excerpts.

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The next morning, I had stabilized enough to move to the coronary care unit. The dilation issue with my eye was resolved and I started responding to commands and answering questions by shaking my head (I couldn’t talk with the tube blocking my vocal chords). Despite the fact that I was alert and responding, I don’t remember much in the hours and days following the cardiac arrest episode.

My sister Sisi arrived that morning. While she and Barbara were in the room with me, I used my limited sign language skills to communicate with them. Barbara learned to sign so she could converse with her oldest daughter, Becca, who is deaf. Sisi, close in age to Becca, learned at a young age and studied sign language formally. So, both of my sisters are fluent in American sign-language.

The first-born of my nieces and nephews, Becca stole my heart the minute I first saw her. I was just a kid and I mastered a few signs, which allowed me to talk with Becca in “broken” sign language. Barbara later recounted that I weakly signed to her and Sisi that I wasn’t going anywhere and to tell Sandra and the girls that I would be okay. Barbara interpreted my messages as a way to assure my family that I wasn’t giving up any time soon.

Later that day, Erica arrived from Washington, D.C.  The flight home was uneventful with her friend Maya by her side. Other than small talk and junior high school girl gossip, they didn’t say much. Just as she had been after the heart attack twelve days before, Erica appeared as though the events of the past two weeks were nothing more than a bump in the road.

She later told me that faith kept her from worrying about what could happen and she believed that I would fight my way out of this. I have no memory of when she got to the room, but Sandra told me that I was alert and smiling when she walked in. Erica brought a couple of souvenirs for me, a copy of the Declaration of Independence and a baseball from the Smithsonian Institution. Sandra said I held the gifts in my hands like they were treasure.

Two days after the dreadful cardiac arrest, my lungs continued to clear and doctors considered removing the intubation tube.  The plan moving forward once my lungs had stabilized was to consider options to resolve my heart issues. Unfortunately, as the effect of the sedatives weakened, I beat the doctors to the punch and removed the tube myself.

The tube inserted down my throat was almost a half inch in diameter and long enough to reach all the way to the trachea, which is the “windpipe” that goes directly into the lungs. I vaguely remember what it felt like to have the tube in my throat, and it’s a scary and helpless sensation. Pulling the tube out could have caused tremendous damage ripping through my windpipe, potentially scarring vocal chords and all tissue leading out of the mouth.

Once again, everyone was on high alert. When news reached the waiting room of my antics, Sandra uttered two words that would be repeated throughout the summer, “Now what?” Gathering around the doctor who had resolved the issue, everyone listened intently as he explained what had happened. According to a nurse, I was getting restless and tugging at the tube, and when the nurse turned away, I yanked it out.

Scrambling quickly to stop any bleeding from the throat and continue providing oxygen to my lungs, doctors and nurses stabilized me and put a clear oxygen mask over my nose and mouth. To ensure that I didn’t pull the mask off, the nurse sedated me and strapped my hands to the bed to keep them from moving.

When Sandra finally saw me, I was fast asleep with a mischievous grin on my face and hands tied down. She couldn’t help chuckling with renewed hope because her travieso (troublemaker) was showing signs of life.

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Next Wednesday: Sandra and the girls inspire me to prepare for the fight of my life…

Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life (excerpt #46)

Summer in the Waiting Room, , , , ,
ICU at Kaiser Santa Clara Medical Center
ICU at Kaiser Santa Clara Medical Center – Click on image to read all excerpts

Author’s note: The following passage from the manuscript of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life.  This installment is excerpt #46.

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As Sandra waited for an opportunity to see me come out of recovery, family and friends continued to stream into the hospital. By mid-afternoon, visitors had filled the waiting room to capacity and started to line the walls in the wide hallways that led to the ICU.

The waiting room was a simple and narrow rectangular space, about 25 feet long and 10 feet wide, painted avocado green along the back wall and painted white on the wall adjacent to the hallway. Four small rectangular windows hung on the white wall to allow those inside to look out to the hallway and those in the hallway to look into the room.

Chairs and a few end tables scattered with magazines lined the room, a 20-inch television dangled catty-corner on the right window-side, and a telephone hung near the bathroom door on the backside of the room.

The hallway was sparse and wide allowing gurneys and other medical equipment to easily and quickly maneuver through. Next to the waiting room windows, silver letters and numbers that read, “ICU 2300-2309,” adorned the avocado colored wall.

To the right of the windows were two large non-descript white windowless doors that opened up into the ICU. A plain black phone and a fire extinguisher hung securely to the green wall next to the doors. The floors were made of beige and brown linoleum tiles immaculately polished so the reflection of the fluorescent lights above bounced off the surface.

The wide hallway, usually quiet and serene, buzzed with nervous chatter as visitors steadily arrived on June 18th. Behind the plain double doors in the ICU, I was struggling to stay alive. My blood pressure was 40/30, morbidly below a healthy 120/80, and the oxygen saturation in my lungs maintained a level slightly above 80%.

Doctors monitored me closely as oxygen levels continued to plummet. When oxygen levels consistently stay below 90%, organs begin to lose function causing irreparable damage to the body, especially brain function. Dr. Fisk explained to Sandra that the cardiac arrest episode had done significant damage to my heart and impacted my lungs. The next 48 hours would be critical for my survival.

While doctors were grappling with the breathing problems, one of my eyes had dilated and caused me to be disoriented and confused. My lungs were saturated with fluid caused by the heart’s increasingly diminishing function. Blood pressure had increased to 90/60, but the heart was beating so weakly that fluid kept backing up into my lungs causing my heart to work even harder.

In addition to all of the coronary drugs flowing through my veins, doctors administered Lasix, a diuretic that increases the flow of urine to help clear the lungs of fluid. The fear of my weak heart racing again or slowing to a complete stop required Amiodarone, a strong and toxic medication that prevents the heart from beating at the extremes.

As the day wore on, the team of doctors decided to install a tube into my mouth, through the throat and vocal chords, and straight into the lungs to deliver oxygen to the body. This procedure, called intubation, causes extreme pain and requires patients to be sedated. With the intubation tube sending air into my lungs and the Amiodarone regulating my heart rate, oxygen levels began to rise and I began to stabilize for the time being.

Concerned that the extended time with a low oxygen rate may have caused bleeding in my brain, doctors ordered a CT scan. Hours later, the scan indicated that the episode had not negatively impacted the brain or caused any bleeding. Although I was in critical condition, the ICU medical team had bought enough time for cardiologists to focus on my heart.

Outside in the wide hallways with shiny beige and white floors and avocado colored walls, the crowd of visitors swelled. Before the day was over, Sandra estimated that over 100 people had stopped by to show support, pray, and offer help.

Adding to our already large family, came friends from work, the community, family friends, former players from my coaching days, and Sandra’s friends. At one point, visitors filled two waiting rooms and the hallways that led to them. Hospital personnel concerned about the growing crowd asked Sandra to encourage people to leave.

She told the staff that she couldn’t ask people to leave and she wouldn’t do so.

I used to joke with Sandra that my funeral would be brief and attended by just a few people, but the presence at the hospital on that long day shattered that prediction. Sandra recounts how she was overwhelmed by the support. The love and prayers coming from the ICU waiting rooms and hallways permeated into the room I shared with monitors and round the clock nurses.

The “longest day,” June 18, 2010, finally came to an end. To the relief of all, I slept through the night.

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Next Wednesday: The battle to improve my lung function continues as my heart remains weak…

Monday Meanderings: Turning the Corner in 2014

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García Family - Christmas 2014
García Family – Christmas 2014

Five years ago this month, I was on top of the world. My obsessive quest for career success was in overdrive. After more than a decade as an executive in corporate America, I was serving my second year as chief of staff to an elected official who represented 300,000 residents, president of the high school board of trustees, and co-founder of a leadership academy created in collaboration with Stanford.

In addition to my six-figure salary and high-profile community leadership roles, my wife was a successful elementary school principal and our daughters attended private Catholic schools. I lived in a nice house and drove a late model European sedan. For a kid who grew up in a working-class neighborhood, who could ask for more, right?

Well, I did. Striving for “more,” I worked around the clock pushing myself harder and harder.

Six months later, a massive heart attack brought it all crashing down. A month after that, I was in the ICU clinging to life in a coma and on breathing machines. By the end of that summer, I was a living testament to the miracle of God’s will. I survived a heart attack, cardiac arrest, and a rare lung syndrome.

That’s when the hard part started. I had to completely change my way of life.

Although my mind still works at hyper-speed, 106 days in the hospital and three major health issues have wreaked havoc on my body. I’ve struggled to reconcile my desire to live at the hectic pace I love with the reality that I can only do as much as my heart and energy will allow.

Working hard and the struggles of leadership excite me, but the stress that comes along for the ride is life-threatening. I love Kentucky Fried Chicken, Roundtable Maui Zaui pizza, ravioli and meatball sandwiches, all of which are off limits on my low-sodium, low-fat cardiac diet. I miss working up a sweat in the gym and knocking back a few ice-cold Coors Lights on tap afterwards.

Everything I do now is measured in calculated moderation, a concept that is completely foreign to me. Bland food, light exercise, and no-stress work are orders of the day.

In the years that followed that horrific summer, I’ve been in a daily struggle with myself trying to come to terms with my new life. Faith, family, and friends formed the foundation of my miraculous recovery, so I turned to that same formula to guide me through my dramatic life change. Making that change has been an emotional a tug-of-war.

On one side of the rope is a maturing relationship with God and an evolving understanding of my place in life. On the other side is the adrenalin rush and ecstasy that come with working and playing hard. Swaying in the middle of that taut rope are the elusive concepts of happiness and living life to the fullest.

I spent 2011 slowly recovering, rebuilding strength, and refocusing on my relationships with God, family, and friends. The next year marked my return to the chaos of full-time work. When my professional career came to an abrupt and exhausting conclusion in 2013, I was lost and confused. I believed that the last exciting thing that brought joy to my life had been taken away.

But, I was wrong.

By the end of 2014, the spiritual side of the rope began gaining ground. It was another year without the thrill of professional challenges, meatball sandwiches, energetic games of hoop, or multiple mugs of ice-cold beer. I earned less income than in any other time in my adult life. Nevertheless, 2014 was a glorious year.

All of those things that gave me short-term exhiliration finally began giving way to the bliss of living life for no other reason than to celebrate God’s gift. Faith is no longer just an otherworldly concept. It forms the foundation of how I manage my day. My relationships with Sandra and our daughters, extended family, and good friends are becoming more fulfilling and meaningful.

Although 2014 was a turning point in my understanding of life’s mysteries, I still have much work to do. I need to keep trusting in God and putting my life in His hands. There are more family and friends that deserve my love and attention.

As my journey moves on, I know the long road ahead will meander with twists and turns. I’ll follow the path that God created for me and I’ll continue to celebrate life with those I love.

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I’ve been writing about my life journey and posting excerpts every Wednesday in Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life. Check it out at: https://esereport.com/summer-in-the-waiting-room.