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My “Widow Maker” Was Blocked

De Smet farmer Neil Rommereim doesn’t normally stop to rest during the day, especially during haying season.

But that’s exactly what he did one morning after waking up with pain in his left shoulder and arm.

He thought he might have pinched a nerve. He took some aspirin and went to lie down for a few minutes but the pain only got worse.


“I was thinking that I don't have time for this and that this really hurts, but it never occurred to me that it was a heart attack.”


“I was thinking that I don't have time for this and that this really hurts, but it never occurred to me that it was a heart attack,” Neil said.

Worried, his wife Linda suggested he call the doctor. Neil made the call and was told to immediately go to the hospital.

“He was in a world of hurt when we got there,” Linda said. “I was going pretty fast, and he wanted me to go faster. Whenever he asks me to drive faster, I know it's bad.”

Coordinated care

Neil met the emergency team at the Avera De Smet Memorial Hospital, which included Jodi Jung, the certified nurse practitioner on call that day. An electrocardiogram indicated Neil was having a heart attack. Thanks to eEmergency Jodi had specialists at her fingertips. A cardiologist was able to confirm Jung’s suspicions: Neil was having a heart attack.

eEmergency is an Avera service that streams video feeds between 85 rural locations and a hub in Sioux Falls. With the push of a button, local doctors are linked with specialists who are sometimes hundreds of miles away. This partnership allows for better outcomes for patients with trauma, stroke or other critical care issues.

“I couldn’t believe it. When they said, ‘He’s having a heart attack,’ I thought, ‘Oh, that’s what it feels like,’” Neil said.

eEmergency helped Jodi coordinate a Careflight to the Avera Heart Hospital in Sioux Falls. They twice gave Neil a nitroglycerin tablet under his tongue, but it wasn’t effective. Through consultation with the cardiologist, they decided to try a clot-busting medicine that began working within minutes.


“I was glad we had the eEmergency because I think it definitely gave him a more positive outcome, because we had him out of here in no time...”


“I was glad we had the eEmergency because I think it definitely gave him a more positive outcome, because we had him out of here in no time, and in Sioux Falls, where he could see cardiology right away,” Jodi said.

A blocked widow maker

At the Avera Heart Hospital, a series of tests revealed that Neil’s left anterior descending coronary aorta was plugged. He was taken into surgery to place a stent to clear up the blockage.

“The widow maker, that's what they call it,” Neil said of the blocked artery. “If it gets plugged up, it kills you.”

Linda said the experience was scary. “They hooked him up to all these tubes, which was pretty much freaking me out. I've been in a hospital quite a few times, and I know the more tubes you get, the more serious it is.”

After receiving the stent, Neil started feeling better and was back in the field in less than two weeks.

“I was just very, very fortunate that I could get the care I got at Avera,” Neil said. “If I would have had to go farther, I don't know what would have happened for sure. But I don't think I would have had the quality of life I do now.

“The specialists that I was able to see on e-services made all the difference in the world for me. I feel really good about our hospital being hooked to Avera. I think it's a really good program,” Neil said.

'It could have killed me'

For a smaller community such as De Smet, eEmergency provides a vital collaboration with specialists.

Neil and Linda Rommereim in Hawaii“We know that we don't have a lot of physicians,” Jodi said. “We definitely don't have the specialists. Being able to access them through eCARE saves a trip to Sioux Falls. Specialists are right there if you need them. A lot of stuff we're able to do, we just need somebody to say, ‘Go ahead. This is what needs to happen.’”

It’s also a helpful tool in coordinating transfers with Careflight, allowing Jodi to spend more time with the patient. In a case such as Neil’s, when minutes matter, Careflight is crucial.

“It's a two hour drive to Sioux Falls. He probably got there in 20 minutes,” Jodi said. “Even though we had given him medication to hopefully stop the heart attack where it was occurring, it's still a possibility it could have worsened. The faster we can get patients to Sioux Falls, the better outcomes we have.”

Since the heart attack, Neil is working again but taking it easier with shorter days and more time with family. It’s still hard to think that he had a heart attack.

“I came through it so well that it's even hard yet for me to grasp that I had a heart attack,” he said. “A year and a half later, it's still hard for me to realize that it could have killed me.”


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Neil Rommereim

Neil Rommereim, De Smet, S.D.

De Smet - Neil

Neil Rommereim farms near De Smet, S.D. He had pain in his shoulder one morning and was later diagnosed as having a heart attack.