Inside Artery Disease: Peripheral and Carotid Artery Diseases
OCT 28, 2024Just as the pipes in your house can become clogged over years of use, the human body’s miles of arteries can become narrowed due to the buildup of plaque.
Read MoreLarry Lavelle has helped deliver babies over the phone, instructed people on how to do CPR until the rescue squad arrives and put out "help an officer" calls that bring backup to police officers in danger. He was the last person to think he—the Sarpy County 911 director and emergency manager-- would be calling 911.
"I'd quit smoking six months before. I didn't get exercise but I was never heavy. I went through stress tests. I had no symptoms...I had a false sense of security," Larry says.
Everything changed that Sunday. Larry went to church, had his usual Italian Scramble omelet at one of his favorite restaurants and was trimming trees with his son while his grandson played nearby. "I felt like I had heartburn but I continued to work. After about 15 minutes I said, 'This isn't really happening. This is something different here.'"
The 56-year-old who'd been a Douglas County 911 dispatcher for 25 years, and the Sarpy County 911 director since 2005, was having a heart attack."I thought, 'For 30 years I've been telling people to call 911. Asking them: What are your symptoms here? Telling them: I'm sending a rescue squad.'"
He told himself not to get anxious because his training taught him that would compound his problems. "But I'm thinking in my mind. 'This is really something.' Then I started sweating profusely." He rushed indoors and his wife—a nurse—recognized the seriousness of what was happening. They called 911. "I had no crushing chest pain, no numbness. Because of my background I knew in the beginning everyone has a moment where they think it's 'just heartburn.' My knowledge assisted me to just call."
One of the first people to arrive was a dispatcher who used to work for Larry and was now a firefighter. "It was nice to see a friendly face." Larry continued to tell himself to not become anxious. "I thought, 'Don't compound this!' My knowledge—I don't know if it was a blessing or a curse.'
In the ambulance, a paramedic used a sophisticated portable electrocardiogram, which records 12 different electrical signals from the heart. He confirmed for Larry: "Yeah, you're having a heart attack."
The medic was able to wirelessly transmit the ECG to CHI Health Creighton University Medical Center to mobilize the cardiac catheterization team before Larry arrived. Knowing what was happening and that everyone was waiting for him was reassuring: "The paramedic told me, 'The STEMI team (for the most serious kinds of heart attacks) is there. They're ready for you.'
"I roll into the ER, as fast as I can imagine." There he ran into someone else he knew, a doctor who's married to an acquaintance. The staff kept him calm and physicians explained what would happen. "They moved swiftly. I was joking with the nurses a little bit and then 'BOOM' I was out."
Thomas Lanspa, M.D., the cardiologist who was waiting for Larry, remembers "one of the arteries had very tight blockage, about 95%." What Larry experienced was terrifying but all-too-common: Dr. Lanspa alone handles about 300 cases like Larry's a year.
CUMC's cath lab is also one of the highest volume labs in the country to do cardiac catheterizations and interventions through the radial artery instead of the femoral artery .That's what doctors did in Larry's case: they went through the radial artery in his arm instead of the femoral artery in his leg. Studies show several benefits to this option, including lower incidence of major bleeding, fewer complications, fewer days in intensive care and generally better outcomes. The CUMC cath lab has done almost 11-thousand cases through the radial artery since 1998.
Today Larry marvels that it was less than 90 minutes from the time he and his wife dialed 911 to the time the procedure was done and he was awake. It was only 63 minutes from the time he arrived at the hospital to when the angioplasty was completed. The procedure's used for the most serious types of heart attacks. A catheter with a small balloon tip is inserted and inflated to open a blocked artery. American College of Cardiology/American Heart Association guidelines recommend a door-to-balloon interval of no more than 90 minutes because delays increase a patient's risk of death and can seriously damage the heart muscle.
"At the time I thought, 'Wow, I feel great. I can probably leave. They did that and I'll get out of here. I have things to do.'" He soon found out that wasn't the case. Larry had to stay in the hospital and then go through rehab. He was instructed by dietitians and physical therapists and learned about all kinds of services and classes that were available to him. "I felt like it was really individualized care. They were concerned about ME."
He says he had the heart attack after "years and years of not eating well. There isn't a double cheeseburger that didn't like me." Today he watches what he eats and runs outdoors when the weather's warm and uses a treadmill at work when it's cold. He checks his heart rate and visits his cardiologist. "My last checkup he told me, 'Everything looks great.'"
The longtime 911 guy says don't hesitate to make that call if it happens to you. The first responders will get you to where you need to be and to the right people: "The doctors and nurses were waiting for me on a Sunday morning. The speed and the efficiency of the team really impressed me. The team was there and they got me right in."
Just as the pipes in your house can become clogged over years of use, the human body’s miles of arteries can become narrowed due to the buildup of plaque.
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