It was a brisk March day. Colorado had seen its first death from the novel coronavirus two days before. Ski resorts started shutting down and the state legislature officially suspended its work.
In northern Colorado, Fort Collins natives Paula and Sam Trujillo had been following recommended guidelines for physical distancing and staying home. The couple, who’d celebrated their 50th wedding anniversary a few months earlier, were already missing their grandchildren. With Sam being immune compromised, though, they knew it was best not to have regular visits with family.
Sam was helping Paula with spring cleaning their home when he experienced a shooting pain move across his chest.
“The first one buckled me down to the floor,” he recalled.
Then seconds later, he experienced another crushing pain.
“I was nervous about it,” he said. “I thought I was actually having a heart attack.”
He and Paula decided to go to the emergency room — a decision that may have saved Sam’s life.
Chest pains: Symptoms should not be ignored during COVID
Health care professionals are noticing that patients, fearful of becoming infected with COVID-19, are waiting too long to seek medical help during the pandemic.
“We are seeing people who should have come to us sooner, whether for a heart attack, stroke, infection or other issues, like appendicitis,” said Dr. Jamie Teumer, longtime emergency room physician and medical director of the emergency departments at UCHealth Longs Peak Hospital in Longmont and UCHealth Medical Center of the Rockies in Loveland.
“The morbidity and mortality for these simple things have increased because of fear of coming to see us. That delay is causing loss of tissue, loss of lives, and it is not necessary. We’ve done all the measures to make sure you are safe,” Teumer said.
“We have all sorts of protective measures set up the minute you walk through our doors to the minute you leave,” he said. “There is no reason to let any fear deter you from coming to us.”
The Trujillo couple admits they too had reservations about going to an emergency room during the time of COVID-19, but they also knew it was the right thing to do.
A hospital visit for chest pains during a pandemic
At UCHealth Poudre Valley Hospital emergency room, doctors ran a number of tests to see what was causing Sam’s symptoms.
Sam hadn’t actually had a heart attack, but he failed a stress test that proved his heart wasn’t operating properly. Sam was admitted to Poudre Valley Hospital that night with plans to have a stent placed in one of his main arteries to open up blood flow to his heart.
“I was able to be by his side as things were just starting to get sketchy with the virus,” Paula said.
Paula had planned to stay that night, but that evening UCHealth’s visitor policy changed to provide more protection from COVID-19. Only one visitor per patient was allowed in a 24 hour-period. Paula went home that night and returned the next morning to be at her husband’s side as he underwent more testing. (UCHealth’s current visitor policy may be found here.)
“At this point, the virus was the least of my worries,” Paula said. “Our hospital stay almost became a distraction. I didn’t have time to focus on the pandemic — and in a way, that was good.”
As Sam was being readied for surgery, news came to Paula that doctors needed to do more than a stent. He needed a quadruple bypass.
Addressing coronary heart disease
The coronary arteries supply blood to the heart muscles. Like all other tissue in the body, the heart muscle needs oxygen-rich blood to work, and oxygen-depleted blood must be carried way.
Coronary heart disease (also called coronary artery disease) occurs when the innermost layer of the coronary arteries become inflamed and narrowed. This is caused by a buildup of fatty deposits called plaque, and these deposits may start as early as childhood and continue to thicken and enlarge throughout life. This thickening can cut or block blood flow to the heart.
“The chest pains Sam had experienced were not from a heart attack, but left alone, it very well might have resulted in a heart attack,” said Dr. Hao Pan, a cardiothoracic surgeon with UCHealth Heart and Vascular Center – Medical Center of the Rockies.
“If the heart can’t get good blood supply and oxygen, then it doesn’t function well,” Pan said. “Sam’s chest pain was trying to tell him something was wrong. Having pains at rest — that’s when you really worry about these patients. Those are the red flags you don’t want to miss.
“If you are really in distress, you need to show up and get checked out. You could go to bed and not wake up the next morning.”
Now, a quadruple bypass
Sam was transferred to UCHealth’s 187-bed Medical Center of the Rockies for surgery. There, many protocols were in place to ensure safety of patients during the pandemic.
“UCHealth has done an extraordinary job of segregating COVID patients from other patients so we don’t add to that risk,” he said.
The March 19 surgery went well, and Sam recovered for one day in the hospital’s intensive care unit and then transferred to its progressive care unit the next morning. In all, he was at Medical Center of the Rockies for five days. The visitor policy had changed once more as hospitals began to deal with a surge of COVID-19 patients and Paula wasn’t able to visit her husband at all. However, in place of her being by his bedside, Pan and the nurses kept Paula abreast of Sam’s condition via phone and FaceTime.
“The nurses were so good keeping me up to date, and Dr. Pan called me daily to let me know what was going on, what the plan was, and where Sam was going to be. He even took a picture with Sam, and one time he used FaceTime so I was able to see Sam. Dr. Pan is so caring. I was very concerned and he put me at ease. So when he’d call, that’s how I’d address him: Dr. Rockstar.”
Getting back home after open heart surgery
Nurses had Sam sitting up in a chair the day of his surgery. Walking was more of a challenge because of the tightness in his legs — for a single bypass, doctors take a vein from the leg to use in the chest to redirect blood flow to the heart.
“The therapy people at the hospital do a good job and the nurses too,” Sam said. “They were on top of everything. If you had a question, they had an answer, and they didn’t mind you asking questions.”
Over several days, Sam learned how to do strengthening exercises and implement lifestyle changes once he returned home. In some surgery cases, going to a rehab facility after such a major surgery would be an option, but because of COVID-19, the risks for an immune-compromised patient such as Sam was too high, Pan said.
UCHealth arranged for a home health care team – an occupational therapist and physical therapist — to visit Sam daily.
“We do all this operating so they can live a long time,” Pan said. “We want him getting back to doing all the normal things again — that’s the goal. What we’ve done for him is stopped his symptoms; prolonged his survival. He can revert back to a normal life, but now he is safer.”
Making changes at home after coronary artery disease
At home, Paula and Sam had hard jobs. While Sam worked to recover, Paula became his caregiver and biggest supporter, but she admits, she feared him getting COVID-19 more out of the hospital than in.
“Here is a man who’s gone through a traumatic surgery, made it through — what if he catches something. That’s all I could think about,” she said.
Over time, she stayed busy by making healthy changes to meals, making sure Sam exercised and took his medications regiments, and eventually began to relax a bit more.
“I still don’t think we are out of the woods,” Paula said.
Each day, Sam tries to walk at least 30 minutes a day. He’s explored local trails, and is staying away from crowds and wearing a mask. Soon, Sam hopes to go fishing.
Recenty, Sam and Paula got the best medicine of all – a visit with five of their nine grandkids. Sam’s son came over for an outdoor barbeque and they spent the evening enjoying their five grandchildren. Then later, they enjoyed a slumber party with their two grandsons.
“That was a pleasure to have them,” he said. “Everything is working out pretty good.”