It was 1 p.m. on a recent Sunday afternoon. I was at my computer, hurriedly finishing an article for the Montgomery County Community College. My deadline was that evening.
As my two fingers flew over the keyboard – I'm a former newsman from the era when the clicking of typewriters filled up the newsroom – an excruciating pain shot up my chest. It progressed up my esophagus, to my neck and throat. I felt as if a bag of screws and needles suddenly exploded inside my chest.
Simultaneously, pain shot from my left elbow down into my fingers. I tried to ignore it. Only two more paragraphs were left to complete the articles.
First thing not to do: Don't self-diagnose!
I told myself that the pain was in the center of my chest. The heart is on the left side. A heart attack is usually accompanied by a pain shooting down from the left shoulder, not the left elbow.
Just a week earlier, I had passed a thallium stress test with flying colors – the kind in which a dye is shot into your vein and you walk, then nearly run, on a treadmill. The physician's assistant called me at home that very evening to give me the good news. For a man of 76, I had done extremely well.
My diagnosis: This pain in my chest was not a heart attack.
I do suffer from gastric reflux, as well as occasional spasms in the stomach and esophagus. My diagnosis: This was a series of severe spasms in my chest.
I did concede that the pain was worse than I had ever experienced before – so bad that it would not permit me to continue typing. I called out to Dalia, my wife of 53 years (and a heart patient). I told her of the pain. The intensity of it made me want to lie down, so she helped me to the bed.
With my head on the pillow, I grabbed her hand as if holding on to a lifeline. She stroked my head to calm me down. I began a series of relaxation exercises: Deep breathing, imagery – a mental exercise recalling pleasant moments, experiences. I revisited trips to Israel and to our family there.
Second thing not to do: Don't take medication prescribed for another person.
Advisories, which pharmacies give patients along with the medications they pick up, say, often in capital letters: DO NOT SHARE THIS MEDICATION WITH OTHERS FOR WHOM IT IS NOT PRESCRIBED.
"What do you think?" I asked Dalia. "Should I take one of your nitroglycerins?"
A nine-year veteran of heart disease, she knew the power of nitro, as it is commonly called, to stop chest pains. She hesitated a bit, then agreed.
I took a nitro and placed it under my tongue, as she had instructed me. Soon, the pain began to let up. After a few minutes, I took another nitro. The pain receded almost completely. Yet even though I knew that nitro is commonly known as a medication against chest pain caused by heart disease, I continued to insist I was suffering from spasms.
I decided not to return to the computer for fear that the spasms would return. The two remaining paragraphs could wait.
But, First – Yogurt!
However, three books due at the library that day had to be returned. We also needed a few items from the supermarket. And so, we got into our car and went on our errands. After half-an-hour, during which I was pain-free, I convinced Dalia that our last stop should be at the local ice-cream parlor for some fat-free frozen yogurt.
It was an unusually warm day for early November. She agreed.
When we returned home, I sat down at my computer.
The pain returned.
Third thing not to do: Don't put off calling 911.
Throughout the pain episode, Dalia urged me to get help – to call 911. I refused, convinced that I only had spasms.
"I'll sit in the E.R. for hours, and then they'll say it was just spasms and send me home," I said to her. It had happened once before, though I was a couple of decades younger.
I also refused to call Ed, a friend and neighbor who is a doctor. I didn't want to bother him. And since it was Sunday, our doctor wouldn't be available, I said.
I decided to finish the story and e-mail it to its destination with Dalia's help. Pain or no pain, I still had a deadline to meet. I was convinced that with the task completed, the stress would lessen, and the spasms, caused by tension, would stop.
I was wrong.
I called 911.
In the ambulance taking me to Abington Memorial Hospital, a medic asked me what medication I had taken. I gasped the nitro story to him.
He chewed me out, saying: "Your blood pressure could have dropped severely," and scowled over at me.
At the hospital, the doctor also bawled me out for using another person's medication.
But he added that nitro can be used to treat spasms. I felt vindicated.
After a series of tests, doctors concluded that I had suffered a mild heart attack. One of my arteries was indeed 90 percent blocked.
The following afternoon, a stent was installed in that artery – a device that would permit my blood to resume flowing normally.
On a scale of one to 10, the heart attack was about a one or two, according to Dr. Emanuel Kostacos, my new cardiologist.
"What would have happened if I had kept postponing calling 911?" I asked.
He said, matter of factly, in the way doctors do, "The attack would have been worse."