I'm Still Alive

The Second Chapter (unfinished)

If I learned anything about myself during my heart failure and the process up to surgery, it’s that I don’t heed warning signs. That has been evidenced so many times in my life. But I have heeded the warning to turn my life over to God instead of trying to run it myself. I know that my health, and welfare, my death and my eternal life are in His hands. Knowing where I’m going when this life is over makes a difference in how I live this life now.

    I could have been bitter about all that I was going through. But that didn’t make since to me. Bad health just happens in most cases. I hadn’t brought this on myself, nor had anyone else. It’s just life. A non-believer would think it sounds like nonsense to say His grace was sufficient for me. But somehow it was. I felt as though God was with me in every step. I never felt fear or anger or regret. I really was lifted up during this particular trial.

    Heart valves regulate the direction and amount of blood flow. While women generally have mitral valve problems, and men, like Arnold Schwarzenegger, have aortic valve problems, both my mitral and aortic valves failed. One was too weak to close (insufficiency, allowing regurgitation); so the blood leaked back into the chamber it was trying to leave. The other was too hard to open all the way, (stenosis), not allowing enough blood to pass through. The valve with stenosis caused a backup leading to an enlargement of one of the chambers of the heart. To round out my situation, I had a pronounced irregular rhythm. 
I trusted my doctors and believed them when they promised me I would feel ten years younger. One of them said, “You just haven’t realized how run down and tired you were feeling. But after your recovery you’ll notice a big difference.” I would remember that later. My family really proved what good and caring people they are.  I will forever grateful to them.

    The day of the surgery was another early start. My husband and I arrived alone. The same brother who came for the catherization showed up before I was wheeled away.
This time he brought my mother. Everything always turned out okay when Mom was there. We all assured each other that everything would be okay.

      When they put you under for these kinds of serious surgeries, they really put you under. You don’t hear anything, you don’t feel anything, you don’t smell anything, you don’t remember anything. And it takes days to get over the anesthesia, with nausea and vomiting eventually setting in. The throwing up is one of the things they don’t tell you about in advance.

    In intensive care afterward, I couldn’t open my eyes and I couldn’t speak, but I could hear. One family member at a time is permitted into the room with you. In order to breathe properly during the surgery, they put a big plastic tube down your throat, after you’re passed out, of course. They can actually vacuum out the saliva. At one point, I felt like I was choking, so I did the only thing I could. I started pushing what felt like bubbles out of my lips with my tongue. My brother noticed that I seemed agitated and was foaming and asked the nurse what that was about. “Good,” I thought, “He got my message.” The nurse vacuumed my tube and I felt better. I heard her telling him that younger patients have more problems than older patients with choking or the sensation of choking.

    Your throat is sore for a few days after the tubing is removed. They keep you in intensive care until you can lift your head. Apparently, my surgeon came by. I can’t remember hearing him, but I heard the nurse telling me to show Dr. Armitage I could lift my head. I struggled, but it didn’t feel like I was moving. She said, “OK, try again and hold it.” I struggled, but I felt like I was in cement. I really wanted that tube out and I was upset that I couldn’t get my head up.

      My mother was with me. Later, when I was out of the hospital, we talked about it and she told me the doctor had been stroking my arm. He did that a lot, or maybe he’d stroke your feet if you were up on a bed when he talked. She said, “You thought you couldn’t move your head, didn’t you? But you did. And you held it up. I knew you thought you couldn’t and it was upsetting you.” You can’t hide anything from a caring family.

    He made me wait a little while longer before they removed the tube, and then finally sent me up to a private room. (I love the private rooms at Mary Washington.) The staff on the heart ward works as an enthusiastic team with an emphasis on getting the patient ready to go home to heal. They make you cough and the nurse’s aides next door applaud when you do. They get you on your feet as soon as possible and make you walk down the halls, dragging your IV on wheels, with monitor wires dangling off your body. As you go down the hall, usually with a relative or visitor, the clerks at the desk cheer for you or comment on your improvements.

      Only you don’t feel like getting up and walking, or coughing, or brushing your hair or even dressing properly. Not only are you nauseous and groggy from the anesthesia, your back, shoulders, and upper arms are in extreme pain by the second day, another thing they don’t warn you about. During the surgery, they can’t risk any involuntary movements. Plus they need to have your rib cage spread far apart. So your arms are stretched straight out and down and are strapped down tightly. The longer the surgery, the longer your body is in this contorted position. New nurses and aides learn immediately, backaches are the number one complaint.

        The surgery I only know about from my reading. All open heart surgery is bypass surgery, since the blood will have to bypass the heart and lungs during the surgery through a machine. Most people using the term bypass, however, are talking about a particular heart surgery that resembles a highway system. When a section of road or roads becomes too congested or slow moving, a bypass is built to route the traffic around the “blockage” but still allows traffic to reach the final goal in a better time frame. When vessels around the heart become blocked or clogged, a section of vein (usually from the leg) is grafted in to allow the blood an alternate route, or bypass. A triple or quadruple indicates the number of bypasses needed.

    I did not have bypass surgery. But like the bypass patients, a tube was put into a small hole in my neck to allow my blood to be siphoned off. It then flowed into a bypass machine, where it received nice, fresh oxygen, and was recycled back into a second tube and into a vein in my neck. My lungs and heart did not function at all during this entire time, but everything that normally requires oxygenated blood got it.

    An incision was made in my skin. The doctor promised to make it as low as possible, but I have a high collar bone, so it had to be fairly high. Then the rib cage, or the sternum, was sawed open. They used big clamps to separate the rib cage and keep it propped open while the doctor did what he had to do, which was to properly install two metal valves so that they wouldn’t fall out. Then he tried to put everything back like he found it. The bones are wired together. My x-rays still show the wires. I still hate to show my scar.

    The valves are registered with St. Jude’s. I have a 99 year guarantee on each one. I got to hold a sample in my hand in the surgeon’s office. They have to be individually sized for each patient’s heart. They just look some flaps in a ring that overlap, and you can push them open, and they’ll fall back into place. In Planet of The Apes, Charlton Heston found a heart valve in the staircase of the subway station. I never caught it the first time around, but it suddenly had meaning after my surgery. The unbelievable part is that he recognized the serial number as belonging to a friend of his. It would take a big computer to quickly id an old valve serial number. 

    The Sunday after my surgery my mother was back in town with a different brother. While he and his wife went down to the cafeteria with their kids, Mom sat with me rubbing my arms below the elbow. I was exhausted. Who sleeps in the hospital? Especially when you need a lot of special care. I don’t know what made her do that, but I really appreciated it. Years later, I asked why. She said she thought I needed it. It was wonderful. Sometimes when I’m tired or sick, I wish I could have her sit by my bed and rub my arms again.

    I knew several older people who had had bypass surgery and they were home on the third day. They kept me 8 days because of complications. The doctor released me finally, he said, because he couldn’t stand to see my husband looking so sad any more. Later he told me he was getting as worried about him as he had been about me.
But he was a trooper in many ways. He was there every day after work. He reminded me to go walking when I didn’t want to. I didn’t care how I looked I felt so bad, but he would get me a robe to go around my wires and brush my hair. He tidied up my room and would nag me to drink something. He fed me if he was there at meal time. I was able to do it myself, but I didn’t have an appetite. He and my faithful baby brother (he could get more blocks of time off from work than the others) went with me to training classes about how things would be when I left the hospital and didn’t have medical people around any more.  They remembered a lot of things later that I forgot.

      When I finally went home, I felt panicky inside. What if something went wrong? That went away after a day or so. My husband fixed my medicine for me every morning; he put the chair in the bath tub so I could shower before he left for work. (No standing in the bath tub, strict hospital orders.) He made sure I got dressed ok,  and then put surgical stockings on my feet. All heart surgery patients have to wear them, but can’t put them on alone because of the delicate state of the chest.