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.