Better late than never

has to be the Spy's mantra this month, but when (if) you read on, you'll discover why.

The story begins

back in 1970. Philip was a long-time mail carrier with Canada Post, and as fit as you might expect someone to be, walking lo those many kilometres day in and day out. But a sudden onset of chest pains at age fifty-nine led to a doctor's visit, a long wait in a crowded office (nurse not triaging the clients) and a heart attack pronouncement once the white-coated one was finally available.

His wife Grace drove him to the nearest hospital (Royal Columbian in New Westminster) where he received the standard treatment for the times--blood thinners, rest, and eventually sent home with a cholesterol-reduced diet and exercise program. Some months later, slimmed down, apparently fit, and with a clean bill of health from the doctor, Philip reluctantly returned to work. He would much rather have packed it in, but the early years of working as a self-employed rural route contractor for all the several hundred hundred mail stops in Surrey (now BC's second largest city) had left him without sufficient pension rights at the Post Office to accomplish early retirement (too few years as an employee).

However, about two years later, a clot formed, or possibly a chunk of the cholesterol-induced plaque broke loose. The result was a massive coronary thrombosis. Philip died in his sleep, apparently feeling no pain. The judge of souls had called his servant home. Grace would survive him until 2004, when she too passed from this life, but at age ninety-one.

Fast forward to 2006

Philip's daughter Joyce, age fifty-nine, with the same Norwegian build as her father, and a high cholesterol problem already under treatment, awakens from an afternoon nap with pains in her neck and jaw. Thinking it's a recurrence of neck joint problems that have plagued her for years, she lies on the floor to exercise the problem out. It gets worse. She wakes her still-napping husband and tells him of difficulty breathing.

"Is there any other pain?"

"It feels like a weight on my chest"

"And your breathing?"

"I can't breathe. Help me."

"How do your arms feel?"

"Pins and needles"

"Both arms or one?"

"Both."

Now, you must understand that their son Joel has been a lifeguard and participated in many lifeguarding and first aid competitions (two-time overall British Columbia champion, and a gold medal in first aid in the Canada lifeguard games). He's been yak-yaking first aid scenarios for ten years, has enough supplies in the trunk of his car to stock a small ambulance, and used to keep oxygen tanks under his bed when he lived at home. At one point, he wrote a senior paper on the use of automatic defibrillators in public places, then persuaded his employers to install them in all the Langley swimming pools.

So her husband knew, and called 911. The first paramedics to arrive took her vitals, did the paperwork, and got her on their stretcher. The second crew were the Advanced life support team (ALT). They heard two sentences of symptoms and took her into their portable hospital to the emergency room at Langley Memorial Hospital, some twenty-five minutes away (well, for someone without lights and sirens, anyway).

By the time hubby arrived at LMH and could gain admittance to the inner sanctum, the well-trained crew working on her had two IVs running with blood thinners, pressure reducers, and a heart-slowing medication. Even to his untrained eye, the heart monitor was showing a graph that looked far from normal.

Minutes later it was clear their best efforts were having little effect on the still-progressing heart attack, so they ordered a transfer ambulance and made arrangements with the Royal Columbian Hospital in New Westminster (see above) to take her into their Cardiac Catheterization lab. Her husband made a few calls, then followed a few minutes later through heavy traffic across the Port Mann bridge and to the second hospital. Having been rushed right past the Emergency ward, she was already in surgery when he arrived, some fifteen minutes after her.

There, the surgeon made an incision in her femoral artery, inserted a dye to track the circulation on a monitor (an angiogram), and quickly discovered that the main artery at the heart was 100% blocked. Until recently, the treatment would have been to run in a catheter with a balloon to the site, then force the artery open by pumping up the balloon through the catheter (angioplasty). Now, there's a more elaborate way. They placed a collapsed metal mesh (a stent) around the balloon and inserted the combination. When the assemblage was in position, the balloon was inflated, expanding the stent with it, and lodging it in the blocked artery to keep it open after the other apparatus was withdrawn.

All went well, excepting a brief fibrillation that underscored the just-in-time nature of the proceedings. Result: the artery scanned as 100% open, the heart monitor suddenly showed normal, and the pacemaker they had on hand (just in case) was shelved. Joyce was immediately sent back to Langley, then returned home a few days later, tired, with activity and diet limitations and some meds, but apparently fixed.

On the one hand, we could conclude "Isn't technology wonderful?" After all, there was nothing like this to apply to her father's condition in 1970. With all due respect to the Lord's agents in the medical profession, however, we must additionally conclude that though the judge of souls had issued her a valid ticket to heaven, he cancelled it at the last second.

And of course you know by now what all this has to do with the column being rather late this month, for Philip was my father-in-law, Joyce is my wife, and all this happened a week ago yesterday. Many changes will be needed, not the least an insurance company prohibition against travel to foreign countries like the United States, but it appears that we have some time together here yet.

And no, diet to reduce trans fats and other cholesterol-contributing agents in the system is but a minor part of the answer. You see, I've always eaten exactly the same food and have a low cholesterol count, no problem at all, despite that my own father died of complications from Parkinson's and arteriosclerosis in 1970 at the age of seventy-one. Heredity and metabolism play an important role in blood cholesterol. There are drugs (statins) that can reduce these levels, but they have unfortunate side effects in certain cases (including Joyce's). Specifically, they can cause liver damage, and at some point one must decide whether the cure is worse than the disease (a typical technolgy scenario).

In any event, we are thankful that Joyce has been given more time on this earth, and have nothing but praise for the paramedics, the hospital staff, and the surgeon. Though all healing (like life and death) comes from the Lord of life, he used many skilled hands in this case, and they all performed magnificantly.

Enough said for this month. And, lest you argue that the topic has nothing to do with Macs, or even computers, the Spy reminds readers that despite the preponderance of such topics here, he bills this as a technology column, not just a computing one. Besides, every one of the many monitors, scanners, and procedures emploued was computer-controlled, and that is the real difference between what could not be done in 1970 and what seems routine today.

--The Northern Spy

Rick Sutcliffe, (a.k.a. The Northern Spy) is professor of Computing Science and Mathematics at Trinity Western University. He's written two textbooks and several novels, one of which was named best in the science fiction genre for 2003. His columns have appeared in numerous magazines and newspapers, and he's a regular speaker at churches, schools, academic meetings, and conferences. He and his wife Joyce have lived in the Aldergrove/Bradner area of BC since 1972.

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