Heart attack

Given the obesity, he probably already had high blood pressure and he's got to be eating way too much salt/junk food or what have you which would just aggravate it. If you throw in some family history and a minor issue (like an arrythmia) then a heart attack at 25 isn't unheard of.

Having two heart attacks in a row makes it pretty iffy that he's going to survive anyhow. The first attack would have done damage and I'm assuming his weight and high blood pressure had already weakened his heart as it is. Then there is the damage probably done just by the stress of the accident. It's probably pretty iffy that he would survive the first attack, especially if the attack occured before he was removed from the car. Unless it was a very mild attack, medical treatment would have to be almost immediate. And, certainly with his weight and weakened heart, any surgery is going to be very dangerous. My guess is you could cut out the second heart attack. He's likely going to need surgery to fix the blockages that caused the first one. His weight is going to be one of his hugest complications. Even if he survives the attack and the surgery, his even more weakened heart is going to find it difficult to pump the amount of blood needed and at the pressure needed to serve such a large body. My guess is that he will be almost totally bed ridden for a very very long time, if he recovers much at all. His treatment is going to include blood thinners and blood pressure meds but I would guess that his doctor and a hospital social worker will both strongly recommend he lose weight. That's about the only thing that will even come close to fixing him. Low salt, low fat diet and exercise - easy at first but getting harder and more aerobic as time progresses. Exercise strengthens the heart muscle.

Thanks, that's helpful. If I cut out the second heart attack (in my never-ending quest to make my characters suffer more and more!), would he need surgery immediately after the first attack, as in emergency surgery as soon as he gets to hospital? Just trying to work with my timeline here. Also when you say he would be bed ridden for a very long time, how long is very long?

Just bumping this in the hopes that someone else with some knowledge of heart attacks and morbid obesity might wander along...

how about 18 years in open heart recovery? I know a little. this guy is probably a diabetic and has rotten peripheral circulation for starters. so, he could have a heart attack and feasibly never feel it- diabetes does a number on nerve endings and he could be found to have significant heart ischemia on his initial ECG monitoring in the ambulance or EKG in the ER. OR, he could be sweaty and nauseated, pale and clammy without a screaming-out-loud EKG abnormality, and at his age and weight, especially if he has any abdominal or other bruising or injuries, the cause of these symptoms could be thought to be from blood loss and/or pain from the other injuries. He could hide a lot of internal bleeding because he's so big, it could be very difficult to see (wouldnt necessarily make a lump or make his abdomen board-hard even though it was significant amount of blood). You decide how long you want it to take before he's at the hospital, and before he gets intervention for his heart-- then decide if you want his heart attack to happen at the scene, or at the hospital, which is all possible, he could even throw a blood clot from his injuries, or a fat "embolus" from a broken bone and have a heart attack or even a pulmonary embolus, which could look like and is just as serious as a heart attack, immediately after injury or any point in time thereafter. At his age, he shouldnt have heart trouble unless it was congenital or associated with drug use, but with his obesity, he is a time bomb for many many problems, not just heart.
Figure out first how your time line runs for when you want him incapacitated, and how long you want him down-- also how close to death should he be--just afraid, or on a ventilator or what, and how long to have him be sick before he is better. Then, do you want him back up to full steam or slightly incapacitated? If you give me a few more specifics, I can offer a few scenarios that would work. I talk too much, so I will try to edit to just the basic information, but this if probably the only thing I DO know very well. If you want, I'd enjoy helping.
NaNoMail me if you want so I dont lose the topic on the page. There are soooo many.

Except for the heart attack(s) you are describing my hubby, who is in excellent health, despite his weight. However, my dad, who was half his weight, suffered a heart attack without knowing it. Not long after that, he suffered a second one and was in a coma for several weeks. Unfortunately, in his case, he passed away, but the doctors were hopeful in the beginning, even though it was his second attack. Let me know if you would like more information.

supermuppet, if your hubby is about the same weight as my character there are several other questions I'd like to ask not related to heart attack, but they may be more personal than you'd want to answer!! Which is quite OK.

SHANKSIN, thanks for the detailed answer -- I sent you a pm outlining a few of my plot parameters, so anymore help you can give would be terrific.