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From the Driver's Seat: Matters of the Heart

Coming close to death is the last thing you’d expect to happen as a 40 year old mom. But when it does happen, you start to confront some very real fears.

“The last thing I heard him say, was, ‘Stay with me…’” 

When you’re a 40 year old woman, the last thing you expect is to be having a heart attack in the back of an ambulance, hearing someone say those words to you.

But that’s exactly what happened to my friend, Nancy Capelle. Just a short three weeks ago, this young Wilton mom, who everyone thought was perfectly healthy, came very close to suddenly dying.

Up until then, Nancy was a very healthy, active woman. She’d never had any major illnesses and there was no family history of cardiac issues. Physically fit, she ran regularly, on average 2-3 times a week. So it wasn’t an out-of-the-ordinary thing for her to run a 5K race a couple Saturdays ago—coincidentally in memory of another young Wilton mom who the year before had lost a fight against cancer.

About an hour after the race, however, Nancy started to feel chest pains that extended to her jaw and arm.

And she almost did something many of us would have done—ignore it. Think about that typical mom or woman behavior: ignore it because you’re likely putting the needs of your kids or someone else ahead of yours. Or, you think, I’ll be so embarrassed if I call the EMTs and it turns out to be just heartburn. Which is the exact thought that went through Nancy’s mind at first. It’s something many of us, including me, would have thought as well.

But when the pain didn’t go away, she did call for an ambulance, partially because the question of childcare factored into the decision-making. Nancy knew how hard it would be to find quick coverage for her kids if her husband, Chris, had to drive her to the emergency room. I know the same thought would have occurred to me too, because I can relate to that need to keep control of the household scheduling, and really, just how likely is it for something catastrophic to happen, right?

It was a good thing she did call for help. Once the paramedics arrived and performed their initial evaluation, they quickly realized she was having a heart attack. They knew they had gotten there just in time because shortly after she was secured in the ambulance with a 12-lead EKG and they started on their way to the hospital, that’s when the situation quickly started to deteriorate.

“Mike [Szumigala] the paramedic—whose nickname was ‘Zoom’ and who was awesome—the first thing he did was he gave me four baby aspirin,” recounts Nancy. “Right after, I felt my heart go into this crazy flutter. And the last thing I said to him was, ‘My heart is fluttering.’ And I heard him say, ‘I know it is. Stay with me.’ And I heard him yell at the EMT, the driver, to pull over. And then I became unconscious.”

Nancy describes a harrowing experience—she had gone into ventricular tachycardia (v-tach), which happens just before cardiac arrest; the heart is in a lethal rhythm and is no longer circulating blood efficiently. She awoke to the two paramedics leaning over her, calling her name to rouse her. Zoom told her he was going to have to start taking more dramatic measures to get her heart into some sort of normal beat. “He said, ‘I’m going to pound on your chest.’ He was watching the monitor to basically find the right time to take his fist and slam it onto my chest,” she says.

Zoom had to hit Nancy twice, but to no avail. Nancy’s rhythms were so bad something very rare called torsades de pointes had happened—basically, the EKG showed that her heart’s electrical beats were reversed. Both conditions Nancy was experiencing, v-tach and torsades, are potentially fatal. Still conscious, Nancy was told that she would have to be shocked—cardiac defibrillation—whether she was awake or not; if they didn’t shock her, her heart would stop completely.

Nancy continues: “Mike told me, 'You’re gonna feel it. Just try to relax.' He pushed that button at whatever time was the right time to push that button, and Oh. My. God. It’s like getting kicked in the front and the back by a horse. It’s just an incredible power that goes through you. It’s really, really powerful. So they did that, and thank god they did, because it absolutely saved my life.

“After they did that I just let out this huge yell, and I started crying and I told him that I was just so scared. Mike was so sweet, he said, ‘I’m not gonna let anything happen to you.’ I felt, my life is in the balance here, it’s in this guy’s hands.”

Mike ‘Zoom’ Zumigala was the paramedic who did take very good care of Nancy, as he and his partner eventually got her stabilized and to the hospital safely. She later learned that she’d experienced something called Spontaneous Coronary Artery Dissection (SCAD). It’s something extremely rare, so rare that few, if any, cardiologists specialize in it. Nancy was told that doctors know little about why it happens, but that they more frequently see it in women in the age range of 38-42; they also suspect it has something to do with hormone levels.

But what she also began to learn later was how hard this struck a nerve with her: it was almost unfathomable just how serious things had been in the ambulance, just how touch-and-go it had been. Her initial thinking had been something like this: honey, you stay home with the kids; I’ll just go down to the hospital, get it checked out and come home. “My peace of mind was having Chris at home with the kids.”

Suddenly she had to cope with the emotional reality of everything that was unexpectedly more enormous: “How fast things can change in the blink of an eye; that one day your life is one way and then all of a sudden it’s possibly…not,” she says.

The same emotions echo for Nancy’s husband, Chris: “You think, ‘what if we didn’t [call]? What if something else had happened? What if we had been on vacation out of the country like we were three weeks before and this had happened?’ That hits you later.”

We’re moms; we tend to shuffle aside things about ourselves because we’re preoccupied with taking care of those we love around us; we usually think, I’ll just deal with it later. We minimize: calling 9-1-1 seems just a bit much. Other things take priority. 

Chris points out something else: “This happens to other people. You hear about this happening to someone else…” and Nancy chimes in, “but this could never happen to us.”

But it did happen to them, and for those of us who know Nancy, it happened to someone we know well. Everyone was shocked, even the nurses who treated Nancy at the hospital were taken aback at the anomaly of this young woman in the cardiac ICU. 

The good news is that Nancy is now home and doing nicely. For the time being, she’s wearing a LifeVest™—a wearable, all-in-one heart monitor and defibrillator that operates on some very smart technology. The doctors are confident that she will heal herself and recuperate fully. While there are very little data about why SCAD happens or what that means for Nancy’s future heart health, the doctors tell her they see no reason why she shouldn’t be able to do everything she used to do before the episode.

She’s still processing things emotionally, and tells me that the entire experience has been very surreal. “That day was just an every day. You never think that today is your last day...but I know now that there are possible last days and this will forever change me.”

Then lightening the mood, she jokes that she’s “been hugging everybody I see, and I’m not a huggy person!” 

Nancy and Chris have spent time figuring out how to turn the experience into a positive for others as well as for themselves. Surviving a heart attack taught Nancy several life lessons that she is eager to underscore for everyone, and it’s why she agreed to let me tell the story of what occurred.

There are warning signs for a heart attack, cautions Nancy; don’t ignore them. It’s taking your own health seriously, no matter your age or apparent level of health. She wants to encourage people, especially women, to take better care of themselves and their health. “Don’t consider heart issues to be just a man’s disease; what I had, 80% of the people who experience it are women,” she cautions.

She’s not rushing back to full-time work just yet either, opting to enjoy the everyday moments, like taking the kids to the orthodontist or being at all their activities. “I don’t want to push this aside like nothing happened and go back to the normal routine—then a big opportunity is lost, to get a better balance in life, to find the areas in life you can do better at,” says Nancy. 

Nancy also wants more credit given to all paramedics and EMTs, who she says are unsung heroes who often don’t get thanked for giving such an incredible gift. “He stayed with me in the ER for a long time. That’s how the program’s set up, it’s not like they just pick someone up and drop them off at the hospital and that’s it. Paramedics are part of the treatment team, and they’re vital for information.”

She continues, “You see the EMTs around, and I don’t take them for granted, but I never thought if we had to call an ambulance it would be for me. They save lives every day. You don’t appreciate them until you need them, and then you’re so glad they’re there. I want them to know how important and appreciated they are, and recognize the incredible work they do.”

The Capelles also want to spread the word about the upcoming Hands Free CPR class being taught at the Wilton Library on June 8 at 7:30 pm by the Wilton Volunteer Ambulance Corp. Says Nancy: “Perhaps someone who might not otherwise thought to get trained, now that this has happened to someone that they know, they might spare an hour now to learn about CPR. It’s one hour. One of the things that Chris is struggling with is if something happens again. The nurses said, ‘Take a CPR class. Knowledge is power.’”

It’s one of those things we all think about—what would happen if I were gone, or if something happened suddenly to my spouse? What would my family do? How do I confront my questions about mortality?

Thankfully, Nancy’s still here to help remind us of the important things in life, of the important matters of the heart.

Cardiac Companion June 05, 2011 at 12:34 PM
Hi Bobbi!!!!!! I have thought of you often as well and I wanted to come by and see you in person! I am in cardiac rehab on Mondays, Wednesdays and Fridays with Mary and Dina who are so great. Please let me know if you are ever on a morning shift. Thank you from the bottom of my heart for everything you did for my family and me - I could never thank you enough. I felt so very safe in your care. You truly have a wonderful spirit and I couldn't have had a better ER Nurse. You made such a difference! So looking forward to seeing you again, but this time vertical, not horizontal :-) Hugs Nancy
Trisha Bam June 05, 2011 at 03:15 PM
Thank you Heather for another great Article. We are very thankful that Wilton EMTs and Paramedics were there for Nancy. We have signed up for this week's CPR class on Wednesday. See you there Nancy. I definitely have a hug for you! Trisha
Anne M. Szumigala June 05, 2011 at 06:30 PM
I'm so glad to hear you are doing well, Nancy. I can only reiterate the need for awareness of cardiac disease in women. It remains the number one killer of women. To some extent it is because we fail to recognize the signs and as busy mon's tend to put other obligations before taking care of ourselves. Like my son, Mike, Iam in the medical profession, a Cardiac Nurse Specialist. As such I cannot over stress the importance of "Bystander CPR" and urge all to take courseds when available. Keep up with your rehab and continue to do well. Anne M. Szumigala (Mike "Zoom"s mom)!
Cardiac Companion June 06, 2011 at 12:21 AM
Hi Zoom's Mom! You have an amazing son and I couldn't agree with you more on the cardiac disease issue in women. I am hoping to organize a 5K run for next spring to raise awareness as well as to recognize and benefit our local EMTs and Paramedics. My husband and I are looking forward to our CPR class on Wednesday. All the best to you and your family Nancy
Laura Haywood-Cory September 07, 2011 at 02:23 AM
Nancy, thank you for sharing your story, and thanks to Heather for writing it. If anyone is interested in further info on SCADs, Mayo Clinic has announced two new studies. The info is on the Mayo site here: http://newsblog.mayoclinic.org/2011/08/17/scad-spontaneous-coronary-artery-dissection-studies-at-mayo-clinic/ -Laura Haywood-Cory

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