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Health
'I hit the heart attack jackpot.' Columnist Matthew Hansen on how he got wildly unlucky (but also lucky)

I was standing in the kitchen when it happened. I had just arisen on a workweek Monday and fed the kittens, grinning as they gnawed desperately at their wet food as if it were their last meal on Earth.

I stood there silently, my hands planted on the kitchen counter, my gaze turned toward the morning light streaming in through our living room windows. In that moment I was a 39-year-old who had never had a health problem, who had never had an awful thing happen to him, who had lived something near a charmed life.

That’s when my chest started on fire.

At first I thought it was heartburn, because I couldn’t believe, maybe refused to believe, what my body was telling me. But it got worse, and worse, until it felt like 50 pounds of weight pressed down directly onto my rib cage, until both my shoulders tingled and fiery little embers of pain shot down into my forearms.

I took some heartburn medication. I climbed back into bed. It kept getting worse.

We better go, I told Sarah. Something’s really wrong.

I have written so many stories and columns over the years about people facing all manner of trauma and tragedy.

I have listened to people describe how their lungs don’t work right, or why their legs no longer work at all, or how their spouses can no longer remember their names, or how their best friend died in the war, or how their children, their beautiful angels, have been taken from them by inexplicable disease or senseless violence.

I have sat close to them, and wrote their words in my notebook. I have tried very hard to understand what they were feeling. I did this because I wanted to take what I glimpsed and pass it on to you.

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But now I know that I never understood much about the fragility of life, how truly and almost comically fleeting our time here is. I didn’t truly understand that things can change as quickly as two ravenous kittens can snarf a half can of Purina.

Less than an hour later, I lay on an operating table, hooked up to an array of tubes and machines and surrounded by a platoon of doctors and nurses at the Nebraska Medical Center.

Through the painkiller fog, I marveled at their speed and efficiency, the clipped, code-like phrases they spoke, the purpose with which they moved, almost as if these movements were a matter of life and death.

But they weren’t. Were they? It felt like a TV drama. It felt like pretend. Except I had just asked a doctor, “What’s happening?” and he had met my gaze and said: “You’re having a heart attack.”

I had some follow-up questions, ones I didn’t get to ask until later.

Like: What?

Like: How?

NEBRASKA MEDICINE  

Yiannis Chatzizisis, a cardiologist at Nebraska Medicine who treated Matthew Hansen after his heart attack.

“It’s very rare. I would say, in the span of a year, we see two guests in this age group we call young people, that’s people in their 30s or early 40s,” says Dr. Yiannis Chatzizisis, a med center cardiologist and also now my cardiologist.

“We don’t get those people coming in with heart attacks, really at all. And when it comes to the particular scenario, for your heart attack? It becomes even rarer.”

When Chatzizisis says my heart attack, he’s referring to what doctors saw when they used cutting-edge technology to get a fantastically high-definition view of my heart arteries.

What they saw: No plaque in my arteries. None of the usual markers that show up in 90% of heart attacks, the cardiologist says.

They saw a heart that looked pretty great, except for the fact that there was a heart attack going on inside of it.

After they got a good look at my heart, and realized I didn’t need a stent or other procedure as many heart attack patients do, the platoon of serious-looking medical professionals sort of melted away, leaving me in the care of a couple of kind, wisecracking nurses.

Unbeknownst to me, they called Chatzizisis, the on-call cardiologist, gathered with him in a nearby room and asked one another some more educated version of the following question:

What in the heck is going on in this 39-year-old dude’s heart?

What they guessed then, and what they still assume now, is that I hit the heart attack jackpot, some version of a bizarro coronary Powerball.

A blood clot formed in some other part of my body. Then a chunk of that clot, or maybe the whole thing, moved toward the heart and slipped inside it thanks to a conveniently located hole in my heart.

A small hole in the heart is common — roughly 1 in 4 people have one, and the vast majority will live and die never knowing it’s there, doctors have told me.

But what is highly uncommon is that a clot will weasel its way into the heart and cause a heart attack.

How uncommon? To give you some sense, Chatzizisis says he’s seen three heart attacks like this during his time as a cardiologist. Three. Including mine.

So that seems rather unlucky. I lay in my hospital bed for a day or so after the heart attack and dwelled on the unfairness of it all. I run regularly! I have low cholesterol! My blood pressure is great! I have no family history of heart trouble! I’m 39, for heaven’s sake!

But then, as I recovered and talked more to doctors, it began to occur to me that, after getting horribly unlucky, I had actually gotten wildly lucky, too.

The blood clot picked a relatively good spot inside the heart to detonate. If it had traveled elsewhere, or triggered a more severe heart attack, it could have badly damaged my heart.

Instead, my heart is basically undamaged, and my heart function is normal. This lack of damage also happened because I got from home to a world-class medical center in under an hour, and then they activated a huge platoon of doctors and nurses who moved at breakneck speed.

“Time is muscle. Time is heart muscle. Every minute and hour counts,” my cardiologist says.

And keep in mind: This rogue blood clot could have floated into my lungs or, God forbid, my brain. Then I might not be writing to you today.

If that doesn’t seem lucky enough, consider this: Chatzizisis told me that, in the 1990s, before a point when cardiologists could get a high-definition look at my heart, they likely would have placed a stent inside my heart.

If this had happened during the Bill Clinton presidency, I would have been a 39-year-old with an unnecessary stent in his heart for the rest of his life.

“Overall,” says my heart doctor, “you were on the lucky side.”

I left the hospital 36 hours after entering it. I write this 15 days after my heart attack. I feel remarkably normal.

Doctors are still working to try to figure out where the rogue blood clot originated, what caused it and whether my blood clots too much. I’m on three medications, but that number could be down to one — a blood thinner — as soon as August.

If I hide the bruises on my arms — the bruises left by various IVs and worsened by blood-thinning medication — you wouldn’t have any clue that I just survived a heart attack 10 months before my 40th birthday.

But here is the thing: I am not the same. I’m simply not.

My brush with mortality, my first true glimpse into the tenuous nature of this existence, has made me feel differently about this life in a way I can’t fully explain.

I find myself resorting to clichés: I realize what’s truly important now, and what isn’t. I appreciate things I used to ignore. The first shower I took after I got home from the hospital was the best shower I have ever taken, for example.

But none of that truly gets at the difference inside me since the moment my heart started on fire. It is a feeling that goes beyond my grasp of the English language.

The best way I know how to describe it is to describe to you how I ended my interview with my cardiologist, in fact the last interview I will do as a World-Herald columnist.

“Before we go, I just need to tell you one thing,” I say. It is a thing I’m saying more these days. It is a thing I want to say to you, too, to all the regular readers of my World-Herald stories and columns for the past 13 years.

“Thank you,” I say. “Thank you.”

I meant that. I mean it.

A roundup of inspirational stories from Midlanders with heart

Development
'That’s the way it should be': Visiting HUD Secretary Ben Carson praises north Omaha's Highlander development

An Obama-era redevelopment in north Omaha, Highlander, drew high praise from Housing and Urban Development Secretary Ben Carson on Monday when he popped into Nebraska to highlight urban redevelopment.

Highlander, built on the site of the former Pleasantview public housing development, is now home to about 300 people in 101 apartments, town houses and row houses. Sixty percent are subsidized for moderate-income people, and 40 percent are market-rate.

Carson toured Highlander on Monday and declared it a good example of how urban housing redevelopment should be done.

The Highlander’s mixed-income apartments and town houses fit into the neighborhood architecturally and culturally, and you can’t tell the subsidized apartments from the market-rate apartments, Carson said.

“That’s the way it should be,” he said.

The housing is full, and only eight renters have moved out since the apartments were completed more than a year ago. The nonprofit developer, 75 North Revitalization Corp., combined federal low-income housing tax credits with private financing and backing from Susie Buffett’s Sherwood Foundation, the William and Ruth Scott Foundation, the Walter Scott Foundation, the Daugherty Foundation, the Kiewit Foundation and the Lozier Foundation.

The Department of Housing and Urban Development recently awarded the City of Omaha and Omaha Housing Authority a $25 million grant to help demolish the Spencer Homes public housing development and redevelop a stretch of North 30th Street.

The grant seeks to build on the success of the Highlander. Construction began on the first phase of that $90 million development in 2015 and was completed last year. It includes a community center called the Accelerator, a meeting and event center called the Venue, a large greenhouse and green space for concerts and entertainment. Other buildings house a coffeehouse, a Metropolitan Community College satellite and space for microbusinesses.

Construction is set to begin in August on the next phase, 64 units of senior housing.

75 North will be involved in the HUD-backed North 30th Street Corridor redevelopment, including by building new mixed-income apartments where Spencer Homes residents could choose to live.

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Carson is a former Republican presidential candidate whom President Donald Trump named to lead HUD.

Highlander is also in an “opportunity zone,” a distinction set up by the federal government in 2017 in an effort to revitalize distressed neighborhoods by offering tax relief to investors. Carson sought to highlight the zones during his Omaha visit.

“Some people have complained that it’s just a way for rich people to get richer,” Carson said. “News flash: Rich people are going to get richer anyway.”

You might as well give them an incentive to invest in a way that will help revitalize distressed neighborhoods, he said. Carson spoke to a select group of people, including Rep. Don Bacon, Omaha Mayor Jean Stothert and 75 North representatives.

He said HUD should be focused more on people than on housing units. Carson said combining housing and wraparound services has cut military veteran homelessness in half since 2010. That model should be applied more broadly, he said.

Although Carson didn’t say so Monday, providing support to help people improve their overall lives is a big part of the city’s and OHA’s stated plans for the North 30th Street Corridor/Spencer Homes redevelopment. The timetable for that effort is still in the works, but it’s expected to be completed in phases over the next five years.

The HUD money will help build more than 400 apartments, town houses and homes, according to the city’s grant application.

It will boost the completion of Highlander. It will help connect the new developments and existing neighborhoods with such places as Howard Kennedy Elementary School, the Omaha Early Learning Center at Kennedy, the Charles Drew Health Center and the Highlander Accelerator Building.

City and OHA officials have said people who live at Spencer Homes will have the choice of living in new housing at Highlander, or elsewhere in the neighborhood or city, and will have first rights to move into the mixed-income housing that will replace Spencer Homes.

Photos: HUD Secretary Ben Carson visits Omaha

Articles
'People have awakened': Puerto Ricans call for governor to resign

SAN JUAN, Puerto Rico (AP) — Waving flags, chanting and banging pots and pans, tens of thousands of Puerto Ricans jammed a highway Monday to demand the resignation of Gov. Ricardo Rosselló in a crisis triggered by the leak of offensive, obscenity-laden chat messages among him and his advisers.

The demonstration appeared to be the biggest protest on the island in nearly two decades.

"Finally, the government's mask has fallen," said Jannice Rivera, a 43-year-old mechanical engineer who lives in Houston but was born and raised in Puerto Rico and flew in solely to join the protest.

The protest came 10 days after the leak of 889 pages of online chats in which Rosselló and some of his close aides insulted women and mocked constituents, including victims of Hurricane Maria.

The leak has intensified long-smoldering anger in the U.S. territory over persistent corruption and mismanagement by the island's two main political parties, a severe debt crisis, a sickly economy and a slow recovery from Maria, which devastated Puerto Rico in September 2017.

"The people have awakened after so much outrage," said retired nurse Benedicta Villegas, 69. "There are still people without roofs and highways without lights. The chat was the tip of the iceberg."

The crowd surged along the American Expressway despite the punishing heat — toddlers, teenagers, professionals and the elderly, all dripping in sweat and smiling as they waved Puerto Rican flags large and small and hoisted signs.

One group dragged a portable karaoke machine and chanted, "Ricky, resign!"

"This is to show that the people respect themselves," said Ana Carrasquillo, 26. "We've put up with corruption for so many years."

Rosselló, a Democrat, announced Sunday evening that he would not quit but sought to calm the unrest by promising not to seek reelection in 2020 or continue as head of his pro-statehood political party. That only further angered his critics, who have mounted street demonstrations for more than a week.

"The people are not going to go away," said Johanna Soto of the city of Carolina. "That's what he's hoping for, but we outnumber him."

The territory's largest newspaper, El Nuevo Dia, added to the pressure with the front-page headline: "Governor, it's time to listen to the people: You have to resign."

Rosselló's secretary of public affairs, Anthony Maceira, said Monday morning that he didn't know Rosselló's whereabouts. Asked who was advising Rosselló about staying in office, Maceira said the governor was speaking with his family, and "that carries a great weight." Rosselló's father, Pedro, was governor from 1993 to 2001.

Asked whether the governor should step down, President Donald Trump said that Rosselló is a "terrible" governor and that hurricane reliefmoney sent to PuertoRico has been "squandered, wasted and stolen" and the island's top leadership is "totally, grossly incompetent."

Organizers labeled the planned road shutdown "660,510 + 1" — which represents the number of people who voted for Rosselló plus one more — to reject his argument that he is not resigning because he was chosen by the people.

In a video posted Sunday night on Facebook, Rosselló said he welcomed people's freedom to express themselves. He also said he is looking forward to defending himself as Puerto Rico's Legislature begins exploring impeachment.

"I hear you," he said. "I have made mistakes and I have apologized."

The demonstrations in this territory of more than 3 million American citizens represent the biggest protest movement on the island since Puerto Ricans rallied to put an end to U.S. Navy training on the island of Vieques more than 15 years ago.

Monday was the 10th consecutive day of protests, and more are being called for later in the week. The island's largest mall, Plaza de las Américas, closed ahead of the protest, as did dozens of other businesses. The upheaval also prompted at least four cruise ships to cancel visits to Puerto Rico, and many officials worry about the effect a resignation would have on the already fragile economy.

Puerto Rico is struggling to restructure part of its $70 billion in debt under federal supervision and deal with a 13-year recession through school closings, cutbacks in infrastructure maintenance and other austerity measures.

The islandalso is trying torebuild from Maria, which caused $100 billion in damage, threw Puerto Rico into a yearlong blackout and left thousands dead, most succumbing during the sweltering aftermath.