When a Cardiologist Becomes a Heart Patient: Dr. Paul C. Ho

May 9, 2019April 27, 2019 / Jordyn Redwood / Leave a comment

Today, Redwood’s Fans, I have a special guest blogger for you. Dr. Paul C. Ho is a cardiologist who suffered a heart attack which led him on a journey of self discovery. Today, he shares his thoughts here and I hope you’ll check out his book, Art on the Human Heart.

Welcome, Paul!

I’m a board-certified cardiologist and a cardiac arrest survivor—a heart doctor who became a heart patient. I believe these experiences make me somewhat of an expert storyteller from both a doctor’s and a patient’s point of view. As I reflected on playing these dichotomous roles in the health-care arena, the story of my autobiographical novel, Art on the Human Heart, came to be.

Aside from its anatomy and physiology, are there other functions or meanings to the human heart? The ancient Egyptians and the ancient Greeks considered it to be the seat of emotions. The Bible says, “In the heart dwells feelings and emotions, desires and passions. . . . The heart is the seat of the will and understanding.” For millennia, this centrally located organ has been implicated in our perception of the outside world and capable of generating a behavioral response to our feelings—the very essence of our presence, our being.

But which is the chicken or the egg? The age-old question applies here to the “emotional” aspect of the heart. When we are happy, the heart feels a sense of openness and a certain lightness. Conversely, anger can bring troubling heart palpitations and chest tightness. There is no doubt that “heart emotions” can be influenced by outside stimuli—whatever makes us happy or angry. But could the heart itself be the originator of feelings that may alter behavior and outcome? Is there then a true nature of the human heart?

As a cardiologist, my professional focus is on the physical nature of the human heart. As we all know, unhealthy life habits, such as cigarette smoking, eating fatty foods, and lack of exercise, can lead to the development of acquired heart diseases. Parallel to outside forces influencing heart emotions, external factors can also affect physical changes in the heart. What if the intrinsic nature of the heart can lead to the development of heart disease? For example, in an innately angry or unhappy heart, could the negative emotional tone trigger early heart ailments? Surely in medical literature, we are seeing an increase in reports of such associations.

When I suffered my own heart attack, I was only thirty-nine years old. I was young, living a healthy lifestyle, and did not have a predisposing genetic factor for heart disease—there was no obvious medical cause for my near-fatal condition. Why then did I almost die at thirty-nine? I questioned if the nature of my heart had something to do with it. At the time, I was extremely hard-working and had an angry, perfectionist, and type A personality. Was I subconsciously dissatisfied with my life? Was I unaware of deep-seated unhappiness? Could that have been the cause?

To better understand what happened to me, I wrote my novel to explore the true nature of the human heart through the eyes of a high-powered, high-stress cardiologist. When I became sick, my compassion turned inward toward myself for the first time in my life. Recognizing that well-being goes beyond conventional medical treatment, I dug deeper into the meaning and nature of our hearts. What truly makes us happy? What truly makes a healthy heart? To save ourselves, as I tried to do in the aftermath of my heart attack, we must understand the true nature and desires of our own hearts— nobody else can do this work for us.

I hope you will enjoy my book and learn as much as I did about our true hearts.

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Dr. Paul C. Ho is a cardiologist and a heart attack survivor. He has published numerous medical papers and is a reviewer for several medical journals. Art on the Human Heart is inspired by his love for creativity, exploration, and self-discovery. Dr. Ho studied engineering and medicine at the University of Pennsylvania, Temple, Dartmouth, and Harvard. He was the chief of cardiology in a hospital system and was awarded several patents for his medical device inventions. Dr. Ho enjoys traveling to remote places and has worked in native communities including locations in Alaska. He lives in Hawaii with his pooch, Bear-Bear.

Author Question: Bullet Wound to the Chest

February 22, 2017February 20, 2017 / Jordyn Redwood / Leave a comment

Gwyn Asks:

I’m writing a scene in which a cop is injured during a confrontation with a suspect. I’d like to tell you about the scenario I have in mind and hopefully you can tell me how realistic it is.

ammunition-2004236_1920 Cop, mid-thirties, in excellent health and physical condition is shot with a low caliber bullet from about 10 feet away. The bullet hits his chest, goes through the lung and exits out the back. He’s got colleagues nearby who administer basic first aid and the EMTs get there within 5 minutes. Say about 15 minute drive to the hospital. They radioed ahead so the hospital is expecting them and has an OR ready.

First of all, what are the chances of survival?. Second of all, assuming survival, what are the chances (best case scenario) of full recovery – to the point he can return to active duty. How long would the recovery time be, how soon would he get out of the hospital, and what complications — pneumonia, blood clots, etc should the doctors be worried about?

Finally, if a full recovery is highly unlikely, are there little changes I can make to the scenario to make it more likely?

Jordyn Says:

Hi, Gwyn! Thanks so much for sending me your question.

In short, this is a survivable injury.

You don’t specify in your question whether this police officer is shot in the right or left chest. Right chest would probably be preferred as there are less vital structures on the right side of the chest then the left.

You give your victim immediate first aid and EMS responds quickly. Keep in mind that you’re going to need a paramedic to respond to give more advanced field procedures. A basic EMT is limited in what they can do— CPR, wound dressings, assisting the patient with some of their own medication administration. Depending on the state, some EMTs can start IVs, so if your novel is set in a specific location then I would research this for that area. Assuming he has a paramedic respond then he’ll get an IV, IV fluids, oxygen, and possibly pain medications. Of course, a set of vital signs and cardiac monitoring.

In an urban setting, a drive time of fifteen minutes to the hospital seems a little long. If a rural setting then you’re probably fine but you might need to adjust there as needed.

A bullet passing through the chest is likely going to puncture and deflate the lung. This character will need a chest tube to get the air out of his chest and reinflate the lung. A chest tube can be placed in the ER. This patient would get a CT scan of his chest. If the medical team isn’t worried about any other injuries than this patient may not even need to go to the OR.

A patient with a chest tube will need to be admitted into the hospital. How long it takes the lung to reinflate depends on the size of the pneumothorax or the degree to which the lung has collapsed. Generally, a patient’s chest tube is connected to a drainage box that uses suction to help the lung reinflate. Patients with this type of injury will get daily (or every other day) chest x-rays to see how the lung is expanding. After the lung is fully expanded, the suction is stopped, but the box remains in place. This is generally referred to as placing the chest tube to water seal.

If the lung stays expanded to water seal for one to two days then the medical team would feel good about removing the chest tube. Then the patient would be observed for another one to two days to make sure the lung stayed reexpanded.

Pending any complications, you’re looking at a hospitalization of 4-7 days. Pneumonia is probably your more likely complication. Having a tube in your chest hurts. Because of this, patients don’t want to take deep breaths. This can lead to the smaller air sacs in the lung staying collapsed and trapping bacteria which could lead to pneumonia.

If you add a complication like pneumonia, then you’re easily adding another one to two weeks that he’s out of commission.

If you just stick with a “simple” collapsed lung I would say he’d be out of work for about two weeks. He won’t be physically 100% of what he was before the injury but he should feel back to his physical baseline in about a month.

I would say he can work, but he’s going to have some physical limitations. It would be up to his department what his physical capacity needs to be before he can return to work. Half days at a desk job is not unreasonable for a few weeks.

He’d likely become short of breath during any exertional activity (like running after a bad guy). However, considering his physical shape, he should bounce back fairly quickly.

A nice overview can be found here.

Hope this helps and good luck with your novel!

Fitbit Saves Man’s Life

February 8, 2017February 4, 2017 / Jordyn Redwood / 1 Comment

Fitbit Charge

If you know me and this blog then you know I’m fascinated by weird and interesting medical things. Now I know you might be thinking, “Of course! Fitbits help improve physical activity so that’s what saved this man’s life.”

It’s so much better than that!

This case was reported in the September 2016 issue of the Annals of Emergency Medicine. It describes the case of a 42 y/o male who was a known seizure patient. Emergency services were called when the man suffered a seizure. Upon EMS arrival, the man was noted to be in a postictal state and also in a rapid heartbeat called atrial fibrillation which they treated with IV medication.

Upon arrival to the emergency department, the man continued to be neurologically intact, though still a little sleepy from his seizure. He continued to have atrial fibrillation and the hospital had a protocol that favored electrical cardioversion for a-fib if the patient had been in the rhythm for under forty-eight hours.

Problem was, this man didn’t have any symptoms with his irregular, fast heartbeat. Someone on the medical team noted him to be wearing a Fitbit— specifically one that monitored heart rate and they retrieved the data from his smart phone. From that information, they could clearly tell when their patient went into the abnormally fast heart rate and were able to treat him safely with electricity.

Using activity trackers that specifically monitor heart rate can be useful in many medical conditions where the patient’s heart rate plays a role. I think it would be particularly useful with a particular fast heart rate called SVT (supraventricular tachycardia).

This can be a particularly sneaky rhythm to catch and it would be possible for a patient to be diagnosed with something like anxiety simply because we were unable to ever catch the rhythm. Even patients who receive 24-48 hour Holter monitoring might not have episodes captured.

It would even be useful in capturing certain rhythms that cause very low heart rates and could cause the patient to black out.

The crux is— it wouldn’t tell us the exact rhythm— only that the heart rate was low or high, but from that information we could look further.

Now, I’m thinking furiously about how to use this in a novel.