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Express delivery saves postmaster

Speed is important to have the best chance to survive a heart attack.

New Richmond Postmaster Joe Bolder found that out last week, when he suffered a major attack while at work.

"I wasn't an impressive health specimen, but I wasn't unhealthy either," Bolder said as he prepared to leave United Hospital last Thursday. "It was a huge wake-up call for me."

Bolder, 52, started out his work day May 19 with what he thought was indigestion. He popped a few antacid tablets and eventually the pain in his chest went away.

"I didn't have some of the classic symptoms," he said. "My arms weren't numb or anything. I never would have guessed it was a heart attack."

The next day, he was back at work and the pain returned. This time Bolder was feeling very ill and he was sweating profusely.

A co-worker asked if the local Post Office chief if he was all right, and Bolder responded that he was. They agreed to head to the clinic, however, to get checked out.

When Bolder got up to go, he fainted to the floor. Employees called 911 and the clock started ticking on the emergency.

"The ambulance was there right away," Bolder recalled.

Mary Kay Rice, a paramedic with the crew, was among those who responded to the scene. The crew determined that Bolder was suffering a heart attack and they decided to use the local air ambulance to transfer the postmaster to United Hospital and St. Paul Heart Clinic.

"It was just wham, bam and I was on my way," Bolder said.

The immediate decision to airlift Bolder is a new trend in treating heart attack victims.

Dr. Kenneth Baran, medical director of St. Paul Heart Clinic's catheterization lab, said he encourages paramedics to make the call if a patient shows signs of a heart attack.

"If they're comfortable enough with the decision, we skip the local emergency room and we skip the emergency room at United," he said. "We bring the patient straight into the cath lab."

Bypassing the traditional emergency route can save one to two hours, Baran said, which is a lot of time when you're dealing with a heart attack.

"That can mean the difference between going home in a couple days and going out feet first," he said. "You can usually save the heart muscle."

The direct to the lab approach worked well in Bolder's case. He was on LifeLink helicopter within a half hour and getting his arteries opened up shortly afterward. From the scene to "balloon time," as Baran said, only about an hour had elapsed.

"I felt better 20 minutes after the surgery was done," Bolder said.

"It's a great story for him," Baran said. "This kind of thing is not happening in many places in the country."

Baran said traditionalists complain that medical doctors should be diagnosing heart attacks, not paramedics.

And while sometimes the ambulance crews misdiagnose the situation, causing the cath lab to mobilize unnecessarily, it's worth the extra effort even if a mistake is made, Baran said.

"They're usually pretty accurate," he said. "So far, it's worked well."

Of the 250 cath procedures the hospital completed last year, more than half were initiated by paramedics in the field who mobilized the cath crew early on.

Those impressive numbers will be part of Baran's presentation before the American Heart Association in November. He hopes to convince others in the medical profession that a speeded up process will save more lives.

Count Bolder as one of those satisfied customers who has a story to tell.

By the time his surgery was completed, Bolder had four stents placed in his arteries. One artery was completely blocked, which caused the attack.

"I was shocked when I got out of surgery," he said. "There is no heart disease in my family at all. At my last check-up, when I was 50, they said I had higher than normal cholesterol -- I took some medication for awhile and was fine."

Bolder admitted that he smokes, a habit which ended with his quick trip to surgery last week.

Doctors have directed him to change his diet, get more exercise and take medication to give his heart a fighting chance in the future.

Bolder was discharged from the hospital on Thursday, just a couple days after his medical emergency. Doctors told Bolder his heart muscle wasn't damaged as a result of the event, thanks to the speed of treatment.

The lack of damage to the muscle will help Bolder recover and return to normal activity quickly. He's grateful to not be one of the statistics of younger people dying of a surprise heart attack.

"You hear about it all the time, people dying in their 50s," he said. "Because of the quickness of the responders, they were able to save me."