Thank you to all of you for your prayer for me this week after I passed out Tuesday. Ultimately the doctor at the hospital concluded that despite the chest pain and reported heart stoppage, this was not a heart attack. I plan to see our family doctor in Three Rivers, early this next week, and we'll try to get to the bottom of what happened. Below is a copy of a note with more details that I sent to another doctor-friend:

I feel 100%, but that is still a bit disconcerting, as we don't know the cause of this incident. The doctor released me from the hospital late Wednesday night, saying none of the tests showed any cardiac abnormalities, and that from all appearances (repeated blood tests and EKGs, and an echocardiogram) my heart is quite strong and healthy. After quizzing me further about the events, symptoms, etc., he theorized that it was a vasovagal syncope affecting the Vagus nerve. Basically my understanding is that this means means the nerves controlling relaxation of muscles were overactive.

I'm thankful at the news that my heart is strong. God is good, and I sure appreciate your prayers for me.

I thought I would run some of the possibly related events & symptoms by you, to see if you have any further insights.

Exactly two weeks earlier, I had come down with a flu, and had actually passed out in my classroom. Connie and Abram came to the school that day and picked me up. On the way home, we stopped at the doctor's office and they confirmed that it was simply the flu. I have a history of passing out when sick, or at the sight of other people's pain. So I didn't worry too much about this. Within a couple of days I was back at work and healthy.

I had been carrying a rather heavy load, with a full-time teaching job, another part-time teaching job, and a graduate class in Special Education. The latter two had come to an end, and the first was nearing an end. Tuesday I came home from work feeling happy that the school year was pretty much over. All that was left was the graduation ceremony that night, and the last day of school Wednesday. Then there was a final day Thursday for the teachers without the students, to finish up record-keeping, classroom cleanup, etc.

As I relaxed on our living room recliner waiting for dinner, at around 5:15 PM I began to feel what I thought was heart-burn. Because of my hiatal hernia, that isn't uncommon and I didn't think much of it. As the pain persisted, and became sharper, though, I began to wonder if it was something more. A few minutes later, when Connie called me to the table for dinner, I declined to eat, telling the family of the pain, and added I was beginning to feel a bit light-headed. Joseph immediately went out to his vehicle for his medical bag (he is an EMT). By the time he returned, the family had gathered around my chair and was praying for me. He began trying to get a blood pressure reading and pulse. At that point I passed out. Joseph was quite alarmed as he could not get a blood pressure reading, nor even a pulse at my carotid artery. He later said he was about to put me on the floor and begin CPR, when I began to revive, and he was able to get a pulse.

My recollection is that I woke up in the recliner feeling quite peaceful, but very weak. Family members were calling my name, but I could hardly answer. They asked if I wanted to move to a couch, and I declined. For some minutes I felt so weak it was hard to move or even talk. I just wanted to recline there with my eyes closed.

Meanwhile, Abram (who is also an EMT) called 911, and then also called directly to the county fire station in Springville where he works as a Paid Call Firefighter. We later learned they received the dispatch while he was talking to his fire captain. The fire captain subsequently radioed the California Department of Forestry fire station closer to us to respond to the call (they had heard the county dispatch, and hoped they would also be called in). The CDF unit was the first to arrive, and got me hooked up to some oxygen & took my vitals. The county fire department unit then arrived and also re-took my vitals while asking questions.

Finally, the Imperial Ambulance Company unit arrived from Porterville (a half hour drive). Since Joseph works for them and they know & trust him, they were able to expedite getting the information they needed. By then I was joking with them and feeling much better, despite continuing chest pain, and assured them I could walk. They helped me out the door and down the steps to the waiting gurney, and wheeled me to the ambulance. I was grateful they allowed both Joseph and Connie to ride along in the ambulance. (Eleven-year-old Joel was probably the most frightened by this whole episode, and I was glad that before the ambulance left, he was allowed to come in and look around, and talk with me for a few minutes. Later, though, he was still so frightened and emotional that he didn't want to go to the hospital. It was good that he was required to, though, so he could see I was alright.)

By the time we arrived at the hospital a half hour later, the chest pain had completely vanished, and I was feeling fine. I was wheeled into the emergency room and asked if I could slide onto one of their beds, which I easily did. Meanwhile Timothy, who had already been in town with Brittany and Tirzah, met Connie at the ambulance. He was a great comfort and strength to her. Because Joseph works for the ambulance company, he was allowed to come right in with me. But Connie and Timothy had to go through the normal emergency room visitor protocol (register, go through security, two at a time, etc.)

We arrived at the hospital about 6:30 PM, and as I was settling in I kept watching the clock, realizing the school graduation ceremony would be starting in a few minutes, and I would miss it. (I had promised several of my students that I would be there.) During the next few hours all of my family members came and visited, one or two at a time, and several of the saints we walk with stayed with the family members who couldn't be in the room with me at the moment.

Meanwhile, hospital staff interviewed me, hooked me up to monitors, and ran blood tests and EKGs at least a couple of times. It was a busy night in the emergency room, and plans to transfer me to a regular room were repeatedly delayed by incoming emergencies. Numerous patients were in beds out in the halls, and there were police, firefighters, paramedics, and EMTs passing back and forth. Connie stayed with me, but the rest of the family left late that night. Finally, at about midnight we were taken to a regular hospital room.

The room only had two chairs, rather than a recliner, for visitors, so Connie ended up pulling them together and trying sleep in that uncomfortable situation. Neither of us slept well, as the nursing staff kept coming in to wake me up for blood pressure readings, blood tests, etc.

The next day (Wednesday) I kept imagining my students missing me on our last day of school. We had been told I would likely be released that day after further tests and a visit from the doctor assigned to me. (Our family doctor in Three Rivers doesn't come to Sierra View Hospital in Porterville.) I was grateful for visits from Timothy, Joseph, and Abram at various points during the day.

All morning we waited, but the ordered stress test and echocardiogram didn't happen, and no doctor showed up. Several more EKGs and blood tests were taken, at intervals. We were told the stress test would likely be conducted that afternoon, after I was released, in an out-patient lab. I continued to have blood tests, EKGs and BP readings while we waited through nursing staff shift changes.

Around noon, the doctor (a young, small man we later learned is from Guatemala) came in and asked me to describe what had happened. He hadn't yet read the charts, but had been told that all my EKGs and blood tests showed no abnormalities. He listened to my heart and had me me do various things (stand up quickly, etc.). He was puzzled, and looked forward to the results of the echocardiogram and stress test. He said he would be back at 5:00 to review the tests and let us know what he found. We were disappointed when he said that because they couldn't figure out the cause of the episode, he wanted me to stay another night for observation.

Sometime in the early afternoon a hospital volunteer showed up with a wheel chair. She said she didn't yet know where she was supposed to take me, but said we were going somewhere for some test. When we got to the nurses' station we found out we were going to have the echocardiogram done. The volunteer was a retiree who had worked at the hospital previously. She took us through the maze of corridors and elevators, and after initially taking a wrong turn and having to come back, brought us to the "echo" room.

It was fascinating to both Connie and me to watch the screen as the echocardiogram technician conducted the tests and explained what we were seeing. The "echo" is essentially an ultrasound machine that records the sound waves bouncing back from the organs inside the body. She was recording the test on a special videocassette, and measuring things like the width of various heart chambers. In the end, she said that the echocardiogram would be read by a cardiologist, but that she saw nothing abnormal. In fact, it seemed to her that my heart was quite healthy. But she reiterated that she was not qualified to interpret the results.

We waited all afternoon for the stress test. Several of the saints we walk with came for a visit. I was grateful for the fellowship. The afternoon waned, and 5:00 passed. The doctor didn't show up. The blood tests and EKGs were discontinued (we had been told they would be done for the first 24 hours). At 7:00 PM the nurses' shift change happened. The night nurses were surprised we were still there, and asked what was happening. We explained that the doctor hadn't come at 5:00 and we really didn't know anything more. The RN in charge said she would call the doctor. Apparently she found he was still at his clinic, but said he would come at 9:00 PM.

At 10:00 PM Connie and I decided to prepare to go to sleep. When the nurse saw this, she assured us the doctor would still come. He arrived a bit later, and apologized for the delays. He was still puzzled by the results of the tests, and asked me to once again tell him everything I could about the episode.

As I provided more background info on past fainting history and my hiatal hernia, he seemed to connect some dots that led him to the theory that I had not suffered a heart attack at all, despite the heart stoppage. He said a cardiologist would be needed to confirm his hypothesis, but explained that my parasympathetic nervous system had probably been overactive and caused the Vagus nerve to force a relaxation of the heart and/or coronary arteries that caused a lack of oxygen (thus the chest pain and heart stoppage) and fainting. (I may not be accurately rehearsing what he said, as I don't really understand it.) He said he would order the stress test for the next day as an out-patient.

With that I asked if there were any reason we couldn't go home immediately. He was surprised, and thought about it for a moment. He joked that this would possibly upset the nursing staff, and said he would go talk with them. A while later the RN came in and said with a smile that she was glad I was being released. (All the staff was very helpful, and despite the time delays, we really liked Dr. Montejo, too.) I was instructed to make an appointment with my own doctor to follow up on everything, and learned that the stress test had not been ordered.

We left the hospital at 11:00 PM, and surprised the children by our arrival at home. It was good to sleep in my own bed again. Thursday I went to work and surprised everyone there, as I had called in the previous afternoon with the news that I was being kept overnight again.

I imagine our family doctor will order a stress test, and I would like to consult with the cardiologist, as well. Please pray for wisdom, and if any of you have insights, I would welcome them.