Raymond Warren, a frequent contributor to FlaglerLive, was an assistant public defender in the Seventh Judicial Circuit, in Flagler County. He was assigned homicide cases until his retirement not long after he suffered a heart attack in October 2016. He was prompted to write the following after reading about Flagler County Commissioner Dave Sullivan, who is recovering from a stroke. Though he testified about it when it became a tangential matter in a hearing last September, it is the first time he has described his October 2016 experience in as public a forum.
By Raymond Warren
I wish Commissioner Sullivan good health and a full recovery.
I do not imply or state directly that the following applies to Mr. Sullivan, but the recent news about head coach Mike Leach of the Mississippi State Bulldogs should concern FlaglerLive readers.
As a public service message, please consider the advice given by our previous medical examiner, Dr. Predrag Bulic (who recently died from his own sudden stroke) on the issue of sudden strokes and sudden heart attacks, the latter commonly referred to as the widowmaker.
Dr. Bulic practiced as an emergency room physician before additional study qualified him as a medical examiner, so he had direct experience with sudden strokes and heart attacks. He stated: Divide your weight by two and drink that many ounces of water per day. Coffee, beer, tea, etc., does not qualify as water. As I type this, I have a large tumbler filled with water by my side, which I will soon refill.
I engaged in this conversation with Dr. Bulic after I experienced what my doctor explained was a sudden massive heart attack. I had previously deposed Dr. Bulic about the mechanism of a sudden stroke, and I had successfully defended a first-degree murder case allegedly caused by the debunked theory of shaken baby syndrome involving an interruption in blood flow, so I had perhaps the most basic level of knowledge about the subject matter, but I certainly needed to know more.
Dr. Bulic had stated that when an individual becomes dehydrated enough, his or her red blood cells become sticky and begin adhering to plaque deposited on arterial walls, even if the plaque is considered a minor obstruction to normal blood flow. He had added that the sticky blood cells do not adhere to healthy arterial walls. The red blood cells adhering to the plaque formation, no matter how minor, can form in minutes an instant 100% blockage of the blood vessel. Anyone with any level of plaque forming anywhere in their bodies can suffer a sudden stroke or heart attack or other form of blood vessel blockage.
In my case, I had been outside early one morning working in my yard and on my pool, after a hurricane had damaged my fence. I had already replaced the broken posts but couldn’t locate the needed fence panels. My neighbor showed up with a truck bed filled with panels (we always split the costs and commonly did basic repairs to the joint fence line without telling each other; I commonly went into his yard with tools to repair loose panels). He had parked at Lowe’s earlier that morning after being told that panels would be in that day.
We immediately started work, cutting roots interfering with the new panels where the old panels had been and cutting the panels to fit the sloping fence line. Some four hours later, with a total of about five or more hours in the sun without a water break, I suddenly felt like throwing up. We had one panel to go. My neighbor asked if I could help him get it out of his truck bed. I told him I had hit a wall (bad pun) and left. My heart was racing which, when coupled with an elevated respiration rate that I couldn’t control, caused me to pause and think about jumping in the pool to cool off. I called 911 instead and made it to the ER.
In the ER, the doctor recording basic information asked how long I had waited before calling for help. I told her perhaps three minutes, not more than five. She put down her chart, walked over to me and shook my hand, telling me I didn’t know how many people wait for hours after onset of symptoms before calling for help.
The heart surgeon soon arrived and ordered the prep of an available operating room. She said she had to dictate some notes and would be up in minutes while I was prepped for surgery. An orderly took me to the elevator. As we waited, other doctors arrived. The orderly let them take the next elevator. My surgeon came around the corner and saw us waiting. The orderly stated he had let doctors take the first one. She harshly ordered him to never let that happen again, stating that every minute counted. I began to wonder of the true seriousness of the situation. All went smoothly without anesthesia and the doctor told me she thought it might have been a mild heart attack.
Heart surgeons order blood tests to be taken a certain number of hours after surgery. The next morning, my surgeon walked in and told me that enzyme levels from the blood test established that I had had a massive heart attack and that I should have died but for the quick call for help. She added that if I had another such heart attack, no one could ever do anything to help as arterial walls grow through the stents and they become part of the artery. No one can go through an already placed stent and place another stent to alleviate any new similar blockage in the same artery.
The next time I deposed Dr. Bulic, and after concluding my questioning, I brought up my heart attack. He went into more detail about the mechanism of sudden blockage. A young woman in the room commented that she had recently gone to her physician after experiencing an unexpected problem with equilibrium. After a blood test, her doctor prescribed water, telling her she was the most dehydrated person he had seen in some time. The young woman added that she just didn’t realize that she wasn’t drinking enough water each day.
FlaglerLive readers, this can happen to anyone at any time and sufficient water just might be the answer. And, yes, a high stress job can impact plaque deposits. Yes, I worry about those FlaglerLive commenters who speak of literally wanting to throw up when they contemplate the effect of liberal political policies on their personal health status.
People, it is simply unhealthy to work yourselves up to a level of wanting to throw up over things you don’t fully understand.
Maybe my parents were on to something. I recall my childhood, after the seven young siblings had finished breakfast, my mother turned on the tap in the kitchen sink. We lined up with our water glasses and filled them. We went to the back of the line and drank while approaching the sink. We each drank two glasses of water under mother’s watchful eye. She would intone the mantra of eight glasses of water per day.
And still, I ignored her mantra that hot October day under the goal of finishing a job, not comprehending the danger within. I already possessed the most basic level of knowledge from my cases involving other people. I just didn’t connect it to my own life until too late.
Raymond Warren’s service in the Seventh Judicial District include work in Flagler, Volusia, Putnam and St. Johns counties. He lives in Volusia. He regularly comments on FlaglerLive on a vast variety of subjects, including politics and the law, under the handle Ray W.
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Pogo says
@Ray W.
I met the “widowmaker” August 10, 2015 — and in very similar circumstances. My 70th B-day, is in this coming February. Every day since my MI, from my POV, has been bonus time.
I hope all will heed your good advice.
Be well, happy holidays.
Related:
https://www.google.com/search?q=ejection+fraction
Ray W. says
And you, Pogo, as well.
Ejection fraction is a very important number. Mine was 70% on the day of surgery, about as good as it gets. The heart attack was unexpected, with no prior symptoms. My surgeon said I had relatively little arterial plaque, yet that didn’t stop the rapid formation of the 100% obstruction.
Geezer says
http://cleanupcityofstaugustine.blogspot.com/2017/03/two-doctors-disciplined-in-michelle.html
Dr. Pedrag helped cover up Michelle O’Connell’s murder in Saint Augustine, back in 2010.
Mr. Warren, remember that the friends you keep speak volumes about you.
Ray W. says
Interesting comment.
If hatred for the deceased Dr. Bulic is driving your comment about my conversing with a medical examiner during and after multiple depositions that occurred as part of my job as a death penalty defense attorney, and relaying portions of those conversations to all FlaglerLive readers in hopes that even one person may take simple steps to prevent a disastrous outcome, that speaks volumes about you and says nothing about me.
Please seek professional help for you to better understand whatever emotional trauma you carry in your life. I cannot possibly fully understand the burden you carry on a daily basis.
Geezer says
I wonder if Michelle O’Connell’s family thinks that I need professional help?
Luckily, this forum isn’t a toilet—you’d clog it with your smugness.
You’re just another cog in Florida’s crooked government machinery,
like you good old boy, who has passed on.
Dr. Bulic left a legacy that you are trying to sanitize.
Perhaps a little psychiatric intervention is in order for you, chief.
I hope that the readers here google Michelle O’Connell’s murder
and read into this further. We’ll see who needs “help.”
Stay hydrated…
Ray W. says
Thank you for impliedly agreeing with my suggestion that you seek professional help. I am not saying you are wrong in any way for supporting Michelle’s family and pointing out possible discrepancies and errors arising from the investigation of her death. Your methods, however, leave much to be desired.
You clearly possess a measure of hatred for Dr. Bulic. You then transferred that hatred to me, asserting that I somehow erred in my effort to help others by informing FlaglerLive readers of simple steps they can take to avert possible serious health problems, simply because I provided the source of the information on which my comment was based. Dr. Bulic might have been everything you claim at one time in his life, but that does not prove that his discussion of the mechanism of sudden strokes and heart attacks with me was wrong, much less that it should be dismissed by FlaglerLive readers who could be at risk of sudden death if they ignore his advice. Pogo,above, provided his own personal testimony about the possibilities. I simply represented a Flagler County woman accused of manslaughter in the death of her uncle, which uncle had presented to the hospital with symptoms of a stroke and evidence of severe dehydration. I needed to know more, and I asked Dr. Bulic to explain under oath the mechanism of injury and subsequent death to me.
You then stated that I was being smug, when in reality I was suggesting a positive course for you to consider. In short, I am trying to help you deal with your obvious problem.
Let’s clarify the issue. I have never had anything to do with any coverup of a decade old death investigation in St. Johns County, much less am I trying to sanitize something that I knew little, if anything, about, other than reading bits and pieces of stories published in the Record about a decade ago while eating in the lunchroom of the St. Augustine branch of the Office of the Public Defender.
Criminal defense attorneys, by definition, stand outside any power structure of government. The only power delegated to defense attorneys is the rule-based authority to issue subpoenas under court authority for people to attend depositions, hearings, trials and for records collections. Public defenders cannot be a cog in the machinery of investigations and prosecutions of crimes because they oppose criminal prosecutions. They are the checks and balances against the cogs of investigations and prosecutions of crimes. Yes, for seven years, including four as a senior prosecutor, I served as a cog in the machine, as you might characterize it. Yes, I watched others who prosecuted in ways that differed from my approach to prosecution and can understand how you might consider facets of the Office of the State Attorney as being a cog in the machine. That experience might give me a better perspective of that machine than you possess. Maybe not.
I do suppose that in some way I could be called a good old boy because I was born in Daytona Beach and have lived in the area for most of my life. That the Klan sought the deaths of my father, mother, siblings and me in 1964, because my father investigated and directly prosecuted Klansmen for randomly attacking Black fisherman on a St. Augustine bridge, instead of presenting the cases to a grand jury system that routinely failed to prosecute Klansmen, suggests that I was not raised in a good old boy family. That my father and mother were involved in the civil rights movement from just after WWII suggests that I was not raised in a good old boy family. That my father searched out a local Tuskegee combat airman in 1948 to thank him for his protection of my father’s bomber crew during WWII missions out of Italy (they became lifelong friends) suggests that I was not raised in a good old boy family. That my mother volunteered in the early-60’s to be the only white teacher in one of Daytona Beach’s Black elementary schools (and the only white teacher in the whole county) suggests that I was not raised in a good old boy family. That Mary McLeod Bethune openly supported my father in his first and successful political foray in 1952, taking out a full-page supportive ad in the News-Journal, suggests that my family was not raised in a good old boy family. That my father then appointed a Black minister to a zoning board in 1953, a first in the Old South since Reconstruction, suggests that I was not raised in a good old boy family. That my mother heard that Daytona’s city commissioners planned to order the city manager to forgo applying for federal funds to improve living conditions in the Black community, which information prompted her to organize with Black ministers a march on City Hall, starting on the dirt roads of what is now MMB Blvd., successfully persuading the city commission to vote to apply for funds to pave the roads, build sanitation infrastructure and build public housing in the late 50’s suggests that I was not raised in a good old boy family. That my mother, who possessed a degree in education, taught courses at BCU in the late 60’s suggests that I was not raised in a good old boy family.
That I was always comfortable in a courtroom, as if I belonged there, does suggest that I was once a part of a cog in the machine and that fact might even support, if only slightly, a characterization that I possess a good old boy side to my personality. If that is enough for your standards, I am guilty as charged.
I stand by my suggestion that you seek professional help. Sadly, your anger, and the way it manifests itself in your comments, cannot possibly be a positive force in your life. Please think about it.
Geezer says
“That the Klan sought the deaths of my father, mother, siblings and me in 1964, because my father investigated and directly prosecuted Klansmen for randomly attacking Black fisherman on a St. Augustine bridge, instead of presenting the cases to a grand jury system that routinely failed to prosecute Klansmen, suggests that I was not raised in a good old boy family. That my father and mother were involved in the civil rights movement from just after WWII suggests that I was not raised in a good old boy family.”
Your family sounds wonderful—good Americans…
You should consider writing a book about their exploits—I’d buy it.
My issue is with the deceased M.E.
Seriously, I hope that you enjoy good health for many years to come.
I wasn’t drinking enough water. I will dedicate my next pallet of water purchase to you.
I am a little crazy, but I like it that way—that’s not going to change.
You take care, Mister Ray…
James says
Staying hydrated by drinking water is good, sage advice… for whatever reason you might have.
But with a few caveats.
Most important of all, as good as Palm Coast water is, it’s still wise to filter it via an under-sink water filtration system. This need not be an elaborate setup, but it is a definite necessity. The water here is periodically infused with high levels of chlorine and other chemicals to combat tropical water borne pathogens. These additives can indeed cause long term kidney damage over time… especially in people who have a predisposition to kidney disease. Some folks might not even be aware that they are predisposed to kidney disease… and it can manifest itself in many ways… including acute psychosis.
Always seek a medical professionals advice.
Just my opinion.
BTW, I find a glass of filtered water with the juice of two limes very refreshing… coffee, soda, etc., only occasionally.
Ray W. says
Thank you, James, for providing one of the best reasons to support the existence of the FlaglerLive site: Perspective!
Readers, mostly partisans, may complain from time to time about slanted political viewpoints. Others, driven by venom, will attack well-meaning contributors. Perhaps, from time to time, I get too aggressive in my commentary. To those I have offended, I offer my apologies.
People like you, however, add to the discussion in a positive way. I may not agree with all of your comments, but that is not the point. No one person, at least as I see it, possesses sufficient educational achievements, broad ranges of life experiences, and basic intelligence to see all angles to any story. It takes a village to properly educate the ordinary FlaglerLive reader. This is why I have hopes for Jimbo99. I can see the quality, even if he does veer off the rails from time to time. Oy vey!