Baylor Scott & White

Jerry Caldwell, left, chest pain center coordinator at Baylor Scott & White Medical Center–Temple, shakes hands with Marvin Shoemaker, a cardiac patient at Baylor Scott & White, as Joyce Shoemaker looks on.

Marvin Shoemaker didn’t have a history of heart problems. His primary care doctor had him on a very low dose of blood pressure medication for years.

“From that perspective I was fine,” Shoemaker said.

On June 15, the day before Father’s Day, that changed.

It was a Saturday and Shoemaker and his wife, Joyce, had gone out to lunch and afterwards he worked a little in the garage.

“I wasn’t feeling normal so I went inside where it was cool and went to my desk,” he said.

Shoemaker, 67, said he was feeling some pressure in his chest. He hadn’t experienced anything like it before. To his mind it could have been heartburn. The symptoms didn’t subside so they decided they needed to get to the hospital.

According to Google, the Shoemakers live 2.6 miles, about seven minutes, from Baylor Scott & White Medical Center and they believed it would take longer for an ambulance to arrive at their house than for them to drive, so they headed out.

Also, Shoemaker didn’t want to call an ambulance and find out later it wasn’t a heart attack, Joyce Shoemaker shared.

“I know physicians would prefer that you wait for the ambulance,” Marvin Shoemaker said. “I thought it was a good call.”

Dr. David Gantt, Baylor Scott & White cardiologist, disagreed.

Jerry Caldwell, chest pain center coordinator at Baylor Scott & White Medical Center–Temple, said they want patients to call the ambulance because once contact is made the medical treatments begin.

“They’re getting an aspirin if they haven’t had one, they’re getting an EKG, which the emergency room staff has to see,” Caldwell said. “Ideally, the patient having a heart attack is in an ambulance and by the time they get to the hospital they roll through the ER on the way to the catheterization lab.”

The 911 call starts the process.

The ambulance response time in the city averages seven minutes.

With the first or second minute of contact, the patient would have been prepared for an EKG, Caldwell said. “They would have seen those EKG changes indicating you were having a heart attack and called the ER on the radio,” he said.

Most important, the ambulance has a defibrillator, Gantt said.

Shoemaker was dropped off at the emergency department while Joyce Shoemaker looked for a parking space.

He got in line to check in, he was given a wheelchair so he could sit down and he was taken back to a room. Shoemaker already was connected to a lot of equipment by the time he had the actual heart attack.

Shoemaker remembers getting aspirin and nitroglycerin, and the medical staff going through processes.

“I’m sure they gave me other stuff, but I nodded off to sleep,” he said. “The next thing I remember is waking up to a lot of people around the bed and a doctor holding my foot against his leg and asking me how I’m doing and telling me they used 200 joules to get me back.”

Joyce Shoemaker was in the room at the start. She wasn’t afraid or panicked but knew the situation was not good when her husband’s skin lost all of its color and he turned white as a sheet.

“That’s when the team that does the resuscitation came in and the chaplain ushered me out,” she said.

Shoemaker was taken to the cath lab where two stents were place in the arteries that were blocked, one 99 percent blocked and the other 95 percent blocked.

The Temple medical center sees on average 130 STEMIs, ST-Elevation Myocardial Infarction, a year. For all types of heart attacks they see close to 500 a year.

Advent Health Central Texas and Seton Harker Heights see STEMI patients as well.

The process for treating STEMIs has been in place since the late 1990s; the medication might have varied since then, Gantt said.

The challenge in keeping the process consistent is personnel, he said.

“Doctors come and go, nurses come and go, and administrations come and go,” Gantt said.

Because the Temple medical center has such a high volume of heart attacks, it becomes second nature to carry out those skills in the right order, at the right speed, for patient safety, Caldwell said.

The STEMI heart attack patient may spend 15 to 30 minutes in the emergency department, an hour in the cath lab and are in the cardiac intensive care within 30 minutes.

The hospital stay for a heart attack used to be five to seven days, now it’s two to three days.

Caldwell said his father had a heart attack in 1968 and he was in the hospital for a month.

President Dwight D. Eisenhower was in the hospital for four to six weeks following his heart attack in 1955, Gantt said. Back then there were no medical devices such as balloons or stents, nor were there medications for heart attacks.

“I am more pleased than you can imagine with the care I got here,” Shoemaker said.

Medical providers can come across as abrupt during the process of getting the patient from the ER to the cath lab and the procedure, Caldwell said.

“Sometimes the patient can get a little chatty and we really don’t have time,” he said. “The saying ‘time is muscle’ actually applies; the faster we can get it done the less heart muscle loss.”

Rehabilitation is key, Gantt said.

The American Heart Association was the first to show that the rehab process is vital to survival, he said.

“It has a double digit effect,” Caldwell said.

Shoemaker, an engineer, works from home and he’s back at work.

“I tire easily, but that’s just going to take some recovery time,” Shoemaker said.

He got out of the hospital the Tuesday following his heart attack. He admits to being mostly compliant.

“I try to be reasonable; I’m an engineer so I analyze everything,” Shoemaker said. “A balance has to the found between radically changing everything and enjoying life.”

“I don’t want to live on cardboard,” he said. He wasn’t a fan of the meals he received while in intensive care.

A committed Christian, Shoemaker said he’s not scared that he could have another heart attack, but he does have plans.

“My goal is to be at my 5-year-old granddaughter’s wedding,” he said. “I want to find the balance where I can enjoy what I’m doing, but still respect the medical advice I’ve been given.”

Shoemaker has started cardiac rehab.

“I want to get back to normal,” Shoemaker said.