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Heart happy: Nurse is healthier following medical scare, near death
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By Sally Voth -- svoth@nvdaily.com
FLINT HILL -- Warren Memorial Hospital nurse Kelly Clement shouldn't be here.
She died earlier this year at age 46. But, due to her physical fitness, being in the right place at the right time and, in her opinion, a strong helping of divine intervention, she came back from death.
Not only that, but Clement is actually healthier than she was before undergoing open-heart surgery for a congenital abnormality of her left coronary artery.
Sitting on the couch in her log home in the woods in Rappahannock County, Clement, slim and vibrant and now 47, recounts the day she collapsed in front of two of her four children.
"It was the first hot day we had in March," she says.
Clement's sons, David, 21, and Daniel, 17, were burning brush. She was watering small young trees when she got short of breath and collapsed.
"My kids said it was like I was dead," Clement recalls. "The boys carried me up the hill."
She woke up two minutes later, feeling really sick and nauseous -- "hindsight, cardiac symptoms."
Clement told the 911 dispatcher she didn't want an ambulance sent out, despite the fact she had no energy to stand up. Her husband, David, took her to Warren Memorial Hospital, where the emergency room physician told her to see her family doctor.
"Did I take this seriously?" asks Clement, who also has daughters, Juleah, 19, and Eleasha, 14. "No."
Within seven hours of losing consciousness, Clement felt back to normal. Still, she went in to see her doctor.
"He had a premonition," Clement said, and so when he sent her to get an exercise stress test at Selma Medical Associates in Winchester, he called the practice and asked them to keep a close watch on her.
Clement remembers climbing on the treadmill, thinking how easy it was going to be.
"I exercise," she says. "I'm in pretty good shape."
After 10 minutes and with her heart rate at 150, Clement started getting tired.
"Then, all of a sudden, something happened," she says. "My heart rate jumped to 162. I said, 'I feel really bad right now.'"
The EKG picked up that Clement was having a heart attack. The physician's assistant immediately called 911 and began treating her for shock. Her systolic blood pressure was 40, and her diastolic pressure was too low to register.
The medical office alerted Winchester Medical Center, and Clement was taken straight to the hospital's cardiac catheterization lab. She says she coded on the cardiac cath lab table. An intra-aortic pump was placed inside her.
"From what I heard, that was keeping me alive, that was helping my heart pump out the blood so I had a blood pressure," she says.
The whole time, she never had chest pain.
As the doctors worked on catheterization, they couldn't find one of Clement's coronary arteries. They discovered what caused her heart attack; she had a congenital anomaly -- her left coronary artery was between the aorta and pulmonary artery, said Dr. Steven Cummings, the cardiac surgeon who ended up performing open-heart surgery on Clement.
"It kind of pinched it whenever she exercised," he said. "That's how some of these young athletes will die."
Because of the position of the artery, a stent couldn't be placed, so Clement's chest had to be cracked. Luckily, she sailed smoothly through the bypass surgery.
"I didn't cry over this for two months because it hadn't sunk in yet," she says. "I think because of my faith in God and because Winchester [Medical Center] did everything right. I felt like I was in good hands. I felt at peace. What I needed and when I needed it, between [cardiologist] Dr. [Neal] Gaither and Dr. Cummings...nothing was missed. Had anything gotten missed, I probably wouldn't have made it.
"I didn't even think about it until a month ago that I almost died."
Winchester Medical Center was named an accredited Chest Pain Center with Percutaneous Coronary Intervention last month, said Sonya Gregg, executive director for Valley Health's Heart and Vascular Center.
"We have a protocol in place that when a patient presents either through 911 or through one of the local emergency rooms, and their EKG and their lab work shows that they're having a heart attack, they call a code MI [myocardial infarction, or heart attack]," Gregg said. "They make one phone call to Winchester Medical Center, and that patient is transferred to Winchester, and the cath lab team is there waiting for the patient when they arrive."
This cuts down the time frame between onset of symptoms and when the doctor can begin opening up blockages.
"The national standard for door to balloon [angioplasty] from the time the patient hits our door to the time we're opening up their blockage...is 90 minutes," Gregg said. "We're currently at 63 minutes as our average. The quicker we can fix the blockage, the less damage they're likely to have.
"Kelly was extremely fortunate to be in our care when she arrested. Our physicians jumped right into action."
Cardiac patients in ambulances can be hooked up to an EKG machine and the results wirelessly transmitted to physicians at the medical center, she said. The ambulance would bypass the emergency room and head straight to the cath lab if the patient's having a heart attack.
Cummings said Clement is free to resume her normal activities.
"Hopefully, [she can] lead a normal life," he said. "She looks very good. She was kind of shocked, [saying], 'But I run and I'm very fit.' It was just something she was born with."
Looking back, Clement says as a nurse, she should have recognized the signs. Growing up, she did endurance horseback riding, gymnastics and tried to be a cross country runner.
In her first three-mile race as a junior in high school, Clement's vision went to black and she had to sit down. Last year, she was exercising in the river, swimming against the current, when she became short of breath and lost her hearing and vision.
Clement suspected she might have asthma, but never got around to having it checked. She says she was in denial.
"My whole life, I've been trying to be able to do a 10K, and most of the time, I couldn't finish them because I got short of breath," she says. "For all my life I've been trying to be a good runner."
For the past five years, Clement couldn't run more than a quarter-mile. Now she knows her heart anomaly was causing the problem.
"I was having a heart attack, but I don't have heart damage," she says. "Because of the care I got, I don't have heart damage, which is really amazing."
The scar stretching up her chest doesn't bother Clement.
"This saved my life," she says.
Clement believes God had a hand in saving her life, too.
"I'm very happy that I had a loving God that decided it wasn't my time to go," she says.
Clement plans to run a 10K in April, a year after having heart surgery. These days, she walks and runs two or three miles. Clement is a heart-health advocate, encouraging everyone to walk one to two miles a day.
"When something like this happens, it changes your life," she says. "I want to educate and I want to promote health. I want to get people walking and exercising."
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