Saturday, August 17, 2019

fortnight

On Monday it will be two weeks since I had open heart surgery. When I am not immersed in thinking about the ongoing rehabilitation, taking the meds, doing the walking exercise, and in general contemplating front and center necessities--I am very grateful that the condition was detected so that it could be addressed.  Otherwise there would have been few blog posts in my future. 

Some observations about the experience.


  • One loses all modesty in a hospital. I was exposed at various times and so frequently that I stopped caring who saw what. So what, who sees what. Purging fluids is key post surgery so nurse's assistants were encouraged to encourage me to so purge, congratulating me for the liquid I was able to deposit in a plastic container while they propped me up in the middle of the night.  "Good job" they would say after such a curious victory. And then they had to help me get back in bed.
  • I could not sleep in the hospital. It was not primarily dealing with the rhythmic bells and periodic testing of my blood pressure and temperature. That would have been a challenge had I been able to fall asleep in the first place.  I was speeding every night. I'd gone into the hospital with some tricks to use to help me fall asleep, but they were no contest for the commingling of drugs I was consuming or just my individual brain activity.
  • When I ran road races I would like it when bystanders would accurately tell me how many miles it was to the finish line. Those who thought they were encouraging and said "only 100 yards" when it was five hundred, did me no favors.  To date every doctor and nurse who has looked at my scar after removing the bandage, has said words to the same effect.  "It looks beautiful" they say.  They all need new eye doctors. My scar begins a bit below my collar bone and goes to my solar plexus.  The truth is that it is not beautiful.  
  • It is amazing what they did.  Cracked me open. Stopped my heart. Put in a pacemaker. Removed an artery from my arm. Bypassed, three times, blockages in my arteries. Closed me up. Connected the two separate pieces together with something that amounts to scotch tape for the skin.  And I did not feel a thing....
  • Until later.  Not a whole lot of fun the first three days in the hospital, moving any old way. Burping, for example, hurt. Coughing very painful. Thank God I did not have to sneeze. After a while the pain dissipated, but even now nearly two weeks later I have to take some tylenol or else I will be reminded of what transpired. Feeling good today I skipped the tylenol and then at midnight had to take some.
  • The nurses in the hospital were so positive, and so helpful.  What they were called upon to do at all hours of the day and night was significant. They worked 12 hour shifts, three days a week.  The nurse's assistants were often college students. My university has an experiential education requirement for many majors. Students are required to work during portions of their academic program in lieu of taking classes so that they leave with actual experience in the field. We have a Health Science College. One of the nurse's assistants one day was a Northeastern student. Others were students at other universities. I was taken by their dedication in what had to be a difficult job.  I am an easy patient I believe, but I can imagine some of the grousing they get from people in pain or people just grouchy by nature.
  • Before they knocked me out, I had to be prepped. Several people were in that cubicle getting me ready. One guy was just shaving me clean. Another spoke to me about the anesthesia process, a third had me listen to what they were going to do and sign documents, a fourth came in and wanted to know if I would be willing to participate in a study related to anesthesia. (I declined).  I was also supposed to meet the surgeons, but whatever they gave me knocked me out before we could shake hands.
  • I had read the documentation ahead of time about restrictions after surgery, but still found it difficult to internalize them. Four weeks before driving a car, okay that makes sense. But ten weeks before you can lift anything heavier than 10 pounds.  Ten pounds is not much. A gallon of milk is close.  Laundry detergent jugs can be over 10 pounds.  In the hospital a bunch of blankets were on the floor. I went to pick them up. Not wise. You would be surprised at what you pick up that weighs more than 10 pounds.
  • Not for the first time I have been taken by the power of love and good wishes from friends and family. I received phone calls and e-mails and texts that were, in a real way, therapeutic. The surgeon touched my heart literally, but others did so as well.
The bottom line, however, is that it is a miracle. I'm typing this now.  It may take two and a half months of doing not a whole lot, but by November I ought to have essentially a new heart.  I can go back to this wonderful horn of plenty called life.

Thursday, August 1, 2019

M is for Mortality

I ran a marathon a few weeks before my thirtieth birthday.  At that time I ran 10 miles a day and fifteen on weekends. Then I cut back to five a day.  Until I was past 60 I ran five miles five days a week. In my late forties, I would run five miles on the day of a tennis match to get the nerves out.  And then play tennis.

In the year I turned 50 I won five consecutive tennis tournaments on five consecutive weekends and 6 tournaments out of 7.  On most of those weekends I played two back to back matches on a Saturday, and then two back to back matches on a Sunday.  I have been able to go, up until very recently, 90 minutes consecutively on the elliptical at a decent clip.

Whenever I have had my annual physical, the numbers all come back so glowing that the doctors have been, or have pretended to be, surprised at the kind of shape I have been in.  The only medicine I've ever had to take is for blood pressure which I started after I was eligible to receive full social security benefits.

So it was surprising when a few months ago, call it February, maybe March or even April, I started to feel tension on the elliptical machine after only 10 minutes. I'd have to stop, get some water, and start again.  It got so bad that I had to reduce the resistance on the machine.  When I had my annual physical I reported this and the doc felt I should have an EKG. As usual, no problem. Then a stress test, some ambivalent results that suggested I should take another one with a sonogram.  The second stress test made the cardiologist say, hmm, let's do an angiogram.  There looks like a blockage that will require a stent.

This was not great news. It was in some ways good news because I had been scheduled for a hip replacement and, if there was even a little bit of blockage, clearing that would have been a good idea before I went under.

I started thinking about mortality. The doc described the mortality rates as minimal for the procedure, but 2 out of 1000 is still something.

They did the test and while they were poking around and I was feeling fine on the bed as they, an army it seemed like, were looking at a screen I tried to glance at the screen myself.  I felt pretty good so I figured they would come by and say, "guess what, there's not much in there, we can clean this up with a minor procedure."

Did not happen. Head doc comes up to my head and says, "It does not make sense to put a stent in. You are completely blocked in one artery, and nearly completely blocked in another, and 75 % blocked in a third.  We'll need to schedule you for a bypass in a week or so."

They wheel me out. I see a procession of doctors and nurses.  I schedule the bypass for 8/5.  I meet the surgeon. A nurse draws blood and then, to test for some infection, sticks a cue tip up my nostrils in an attempt, it appears, to see if it will come out of my eyeball. Then she comes back forty minutes later to tell me that she used the wrong type of cue tip and has to do it again. The surgeon seems nice. I looked him up and he gets rave reviews.

It seemed surreal, and still does. 

All day Wednesday through today the following Thursday, I think that this is not real. I feel pretty good.  I have lost some weight by design and now weigh what I did ten years ago.  I have not gone back on the elliptical, but gee before I had the angiogram I had been able to go for 45 minutes, having to stop every 9 minutes or so. I'd go for 9, then another 9, then another 9, and then do 18 minutes without a problem. Apparently one's body builds its own routes when everything is stopped up, so I guess I had built my own routes. Otherwise this blog would require some very fancy software to be distributed from my perch in the sky--putting new meaning, I suppose, to content being stored in the cloud.

I have been told by animate objects (as opposed to the internet) that this is a routine procedure and most people do fine. The doctors also said that I am in very good shape and am a prime candidate for doing well. My pulse rate, from all the exercise, is around 50 and often less.

But still, they told me the procedure. They crack open my chest. They stop your heart. They create a detour for your arteries.  And you feel good as new,. Except for the cracked chest. And the fact that you cant resume stressful activities for 12 weeks.

Sobering for someone who thought he would live forever.

I find that I am irascible.  Could be the new medicine. Could be the anticipation of being cracked open with something probably like an axe. On Sunday we had a spat. It comes with the territory of sharing space.  (I was right of course) I became very tense. For about two hours I sat stiff and felt angry.  (Did not help that the Red Sox played lousy that evening--vu den)  Cant be good for someone who is blocked up to stew. I'm making light of it, but I really did tense up. Nothing went shooting down my arm, but I knew this was not good. Not good to feel this way, and not a good sign that something minor could--I hope because of the blockage--make me so upset.  I'm usually a sweet fellow.  Not a mollusk by any means but, I've been told, fun to be around. Not lately.

They said this buildup has happened over several years and I try to think about manifestations.  I read on the internet (good to scan the internet if you want to, repeatedly, get punched in the stomach) that one manifestation of clogged arteries is high blood pressure. Well, it is possible then that the blood pressure meds giveth and taketh away. Yes, they reduced my blood pressure, but they masked the reason for the elevation.

The good news is that this is 2019 and not 1965 or 1945.