Darlene MuellerThe Power of Denial
Not even a career in nursing prepared Darlene Mueller for recognizing her own heart attack. "Believe me, denial is a very real thing," says Darlene, who in 2001 began noticing shortness of breath while climbing stairs to her mother's third-floor condo. "But I had a way of explaining it to myself. I was busy, I was working hard, and I was tired. I figured this must be what it's like to be in your 50s," she says. "I didn't ever let myself consider this might be heart-related."
In the next several months, she continued working a busy hospital schedule in the obstetrics unit at Mercy Hospital in Valley City, N.D. She also led a busy farm life with her husband Phil, a state legislator, and she helped out with a new grandson in Minneapolis. Despite the fatigue, she looked forward to a long-planned trip with Phil to New York City. "It was our Christmas present to each other and we were excited to go," she says.
On Dec. 12, 2002, they drove from their farm to the airport in Fargo for a morning flight to Minneapolis. "All the way to Fargo, I kept asking Phil to pat my back because it felt like I needed to burp. There was this internal gastric pressure that I couldn't shake," she says. "If anything, I would have guessed it was my gallbladder. Never did I think heart."
When they arrived at the airport, Darlene continued to feel the pressure. "After we went through security, I sat down, then began to feel weak," she says. "I felt my pulse rate drop — nurses notice things like that. Usually my pulse is rapid — about 90, but I felt it drop to 60, then it kept slowing, slowing, slowing. It dropped down to 30, then it started coming back. By this time, I felt very weak, sweaty, almost nauseous. It lasted a few minutes and I remember leaning over. I was still in denial that this was really my heart." Though she felt ill, she and Phil still boarded the plane to Minneapolis. "During the plane ride, I had another weak episode, but this time my pulse rate didn't drop as far," she says. "I figured it was just more of that same gastric pressure."
At the airport in Minneapolis, Darlene napped for 40 minutes. "I had enough time in Minneapolis to rebound, so by the time we arrived in New York City, I felt a lot better," she says. "We had a very good dinner at a new restaurant then we met our tour group. We stayed at a centrally located hotel and walked nearly everywhere. In retrospect, this all seems so unbelievable." Darlene proceeded through the next few days, viewing three plays and taking in several sites including the Empire State Building, Ground Zero and the Statue of Liberty. "I thought I was doing okay," she recalls. "I'd once in a while feel some tightness in my chest and a little shortness of breath, but I'd just take a really deep breath, hoping to oxygenate my heart just in case…"
The "just in case" proved true. They arrived back in Fargo on Dec. 15 and stayed overnight in a motel. "I knew it would be silly for me to be in Fargo and not get this checked, especially since I was still having some tightness and shortness of breath when I walked too fast," she says. "Phil must have noticed some signs, too. When he brought a bagel and coffee to my bedside that morning, he placed the ASK-A-NURSE® number on the breakfast tray." ASK-A-NURSE® provides 24 hour access to registered nurses who listen to symptoms and direct people to the appropriate level of care.
At 9:15 a.m. on Dec. 16, after calling MeritCare's ASK-A-NURSE®, Darlene arrived at MeritCare Emergency Center. "After I'd checked in, I was surprised at how quickly they came and got me — and they brought a wheelchair. I remember thinking, ‘Why a wheelchair? I've just been walking all over New York.' I guess I was still in denial," she says.
In the exam room, she underwent preliminary tests, including a noninvasive heart test called an electrocardiogram (EKG). "A short time later, the doctor came in and told me the EKG had shown I'd had a heart attack. On one level, I wasn't terribly surprised because of how I'd felt, plus there was a family history of heart disease on my mother's side. But on another level, I was blown away. I had always been a very, very active person. I was 55 and had not had many health problems in my life. I was just in very strong denial that there could be anything wrong with my heart."
Three hours later, Darlene underwent further testing in the cardiac catheterization lab at MeritCare Heart Center. An angiogram revealed three narrowed areas that reduced the flow of blood to her heart. One was nearly blocked to the point it required the placement of a stent. She and Phil went home on Dec. 17, both well aware heart disease had entered their lives. Heart disease ranks as the number-one killer of women as well as men. Several steps followed, including participation in a cardiac rehab program in Valley City, a daily regimen of medication and periodic checkups at MeritCare Valley City.
Today, in addition to taking steps to improve her own heart health, including exercise, good nutrition and stress management, she hopes to help others, too. "It's very important that people, especially women, know the symptoms of heart attack, then seek medical help if they have any doubt at all. I know from experience that denial is a very real thing," she says. "My message is don't wait — get help."