As indicated, knowing that time affects outcome, I'll post here an example of a single case. (30,000 words are in the making)
November 4, 2023, around 8 a.m. I have been on the computer as usual, with no problems or issues. My cardiac history is unremarkable. I take one prescription, HCTZ, for borderline hypertension, which seems to be controlled. I had a routine,which means brief, scheduled visit with cardiologist Dr. P. a few weeks ago, with no issues. I had recently gone to NYC with my daughter to see Neil Diamond's "Beautiful Noise" and had walked around the city a little, to restaurant and parking garage.And I had participated in Mechanicville's October Breast Cancer Walk, as usual. All seemed normal. I realize that at my age I can't be surprised at any health issue arising, but that doesn't mean I can't be shocked by such.
Back to the computer. As I sat there, my upper back started to hurt. It's kind of chilly in the room where the computer is because the windows are at my back. The pain persisted so I went back to bed to warm up, but I soon got up and went back to the kitchen area. The pain was so intense that I knew something was really wrong and that I needed to get help. I sensed that I was having a heart attack. There are cautions and warnings about how to recognize a heart attack. But I had no shortness of breath, no nausea, no dizziness or faintness, no arm pain, no jaw pain, not even chest pain. The image of a large rectangular shoebox came to mind, as if it had been inserted in my chest area and had been pumped full of pain. There was no room for anything else. So I knew.
I looked at the clock.The time was about 8:30 a.m. I thought I'd wait until 9 before I called my daughter to tell her I needed to go to the E.R. It was Saturday and their day off. But then I was afraid they would leave to go somewhere, so I called, probably shortly before 9 a.m.
M. called 911 before she got to my house. I don't know how long it took, but Pittstown Volunteer Emergency Company, about 12 or 13 miles away, arrived at my house and then drove me to Samaritan Hospital. I remember the attendant's shirt read J. Lebarron and I asked him what the J. stood for. He said Jay. He was very calm, comforting, and sent in all the testing results to the hospital, electronically.
So a certain amount of time has elapsed since the onset of "The Event": My delay in calling, the call to the Rescue Squad, their travel time to my house, then travel time to the hospital.
PVEC has only Basic Life Suport services, but they did a thorough job of alerting the E.R. of my condition, and I bypassed the hospital emergency room entrance and was brought directly to the floor, where a doctor soon appeared. She did a short evaluation and I was brought to a room where Dr. Benton appeared, as described in my previous rant. And then, I was hurried to the Cath Lab,where, evidently, Dr. M. had placed his orders.
Dr. Maroney, Interventional Cardiologist, entered the Catheter Lab at;
11:49 AM Case Start (His notes)
12:26 PM His final entry before he left.
I never saw him, before or since, except "through a haze darkly" in the Cath Lab, where the conscious sedation that was administered made his dimmed figure seem a mile away. He had spoken to my daughter; I was just the helpless blob.
The point is that since time is of the essence in complete heart blockages, any delay in treatment is dangerous to heart and life. In my case, the time from recognition to treatment was about 3 hours, but it was probably about a little over an hour between arrival at the E.R. and treatment.
It may be unwise to pre-judge the decision made by Capital Cardiology Associates to no longer perform inpatient services, including emergency catheterizations, at Samaritan, because I don't know all the conditions. But they say they will continue to perform scheduled catheterizations. And, for instance, it does not seem feasible or professional for a doctor from CCA to perform such a scheduled procedure without anticipating that the patient may need to be admitted. Then would the patient need to be transported to Albany?
This post is a reminder that just because higher management issues a statement about policy changes (transitions) that are for the benefit of their patients, it might not necesssarily hold true in real time.