By SALLIE SATTERTHWAITE
sallies@juno.com

We were on our morning walk, passing the pond below the house, when, in a moment of rare prescience, Dave said, “Whatever happens tomorrow, I have a feeling things will never be quite the same again.”

It appears that he was right. After a couple of weeks of off-and-on chest pain — pain so atypical of cardiac pain that it nearly fooled a cardiologist — he'd finally made an appointment. “I know what's going to happen,” he lamented. “They'll keep on doing `just one more test' until they find something, and then they'll want to do surgery, and I'll join the ranks of old men talking about their bad tickers.”

As every basic first-aider knows, chest pain of any kind in a man of 68 must be considered symptomatic of a life-threatening illness until that is positively ruled out. But it was impossible to believe this of Dave. He has none of the risk factors you think of first: his blood pressure and pulse are almost abnormally low, cholesterol and triglyceride levels optimum; he doesn't smoke, is not diabetic, his weight is acceptable, he exercises regularly and he's virtually vegetarian.

That's the tough one. I'm so obsessive about fat and fiber in our diet (none and lots, in that order) that heart disease wouldn't dare darken our doorway. (Our friends are shaking their heads incredulously, our detractors doubling over in glee.) Put together Dave's history and the pattern of this pain — not crushing, not relieved by nitroglycerin, no shortness of breath, but definitely associated with some muscle-challenging household chores he'd done recently — and even the cardiologist at Piedmont was ready to dismiss it.

He ordered more tests nonetheless. An EKG showed no changes since previous routine ones. But a treadmill test did wear Dave out more quickly than expected. So the doc ordered catheterization to be on the safe side.

“What did I tell you?” Dave said. “I knew this would happen.” And that's how they found two arteries occluded 90 percent or more. Bad enough to warrant monitoring him in the hospital over the weekend. As he had predicted, this is how a man goes from being husband, father, handyman, boatsman — to patient.

We were stunned. Dave with heart problems? Unthinkable. He was a chemist, you know. Stick to the formula and you get predictable results, every time. Eat right, stay active, avoid toxins and stress, and live long and well. Earlier I said he had none of “the risk-factors you think of first.” There are three others over which he had no control: his gender, his age and the fact that his father died after his one and only heart attack, at 77.

We needed that weekend in the hospital to come to terms with the message in the blurry black and white photos the doctor handed us. The narrowed passage of blood was plainly visible in two of the arteries that enable heart muscle to squeeze blood to the lungs and then back into the body. There was no denying what we saw.

Suddenly the future was foggy. We had been just days from taking off for a few weeks on our little trawler, the nicest weather of the year ahead of us, and now there were decisions to be made, concerns to be addressed that had nothing to do with boating. Even assuming this story would have a happy ending — and we were — Dave reviewed our finances with me again (or thought he did; I tend to glaze over when he starts talking mutual funds and money market accounts). He even discussed the best way to sell the boat.

I nodded where I thought it appropriate, hearing nothing. Something inside kept whispering hoarsely, “This isn't happening. Not to us. Not to him.” We let the girls know, one by telephone, the other by e-mail. I begged off a few committee meetings and posted e-mails to people who needed to know. Talked to our pastors, one of whom called Dave and said he was thinking of buying a boat; was Dave interested in selling his?

The man has a mean streak behind that backwards collar. But he also helped us think through our options. One was angioplasty, with stents to hold open the arteries, restoring good blood flow with relatively little risk and trauma. The other, bypass surgery — a more traumatic procedure requiring that the chest be opened and veins borrowed from elsewhere in the body — statistically offers a somewhat more permanent fix. The decision was ours, and took the whole weekend. Whatever we chose would happen on Monday.

Angioplasty. It seemed to us that Dave's prospects were very nearly as good with angioplasty as with surgery, and at considerably less cost in pain and time. Moreover, if results were not as long-lasting as hoped, bypass could still be done later. Dave was in the cath lab by 10 a.m. Monday, and at about 12:30, the cardiologist, a tall, engaging man who exudes confidence, strode into the waiting room and said both he and Dave had done extremely well. The outcome was very satisfactory.

Again, the pictures proved it. Those previously pinched arteries were now plump with flowing blood. As I stared at them, it seemed my own heart beat easier, and a weight I hadn't even realized was there lifted from my shoulders.

That was Monday. He came home next morning, is a model patient, and if our immediate future is not yet crystal clear, at least the fog has lifted a little.

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