Wednesday, October 22, 2014

This is Heart Surgery

"You don't have COPD."

Great news! When you've spent half your life smoking, and much of that unfiltered toking, that has got to be one of the best things you'll ever hear, especially when you're sixty-five. No tubes in the nose, no iron lung, no caddy of oxygen tanks. A retirement of sitting while your family cavorts around, and without, you.

But that's not you! You are emphysema-free. You--

"It's your heart."

What the fuck?


***

Not that we didn't know that was coming. G-man had a congenital condition, a prolapsed mitral valve, whose only symptom so far had been an irregular-sounding heart beat. But, as Dr Parker explained, these already-defective valves wear out over time. We could either let it ride--in which case he'd die much sooner rather than later--or have surgery to correct it.

Put that way, heart surgery sounds good. We knew people who had had heart surgeries; they seemed happy and well-adjusted post-surgery. We made arrangements to meet with the surgeon and went about our business.

Pro Tip: When you meet with the doctor, take an extra person with you. You as the patient are just not going to remember, or even process, the vital information you're given. And when you meet with the surgeon, take two.

Three of us sat in Dr Postell's office: G-man, his daughter Alisha, and me. We all had note paper and pens. Dr Postell's explained the problem. The weakening valve let too much blood back-wash, so G-man's heart was only pumping at thirty-, maybe forty-percent capacity. That's why he was so winded and exhausted. We had also waited a bit too long before doing something about it--well, we can pin that one on the smoking, I suppose. The doctor did not perform the minimally invasive surgery for two reasons: too hard to get a good view of what was going on, and too high a risk of post-operative stroke. So that leaves...

"Open-heart surgery?" Yes.

The kind where they... "Open the rib cage, yes." Here I'm not sure if G-man's years as a hospital orderly worked for or against him. But he seemed resignedly calm and almost cheery about the whole thing. We compared notes after the meeting, decided we were comfortable with irascible, Old-World Dr Postell, and scheduled the surgery for the end of August.


***

From texasheart.org:

You can expect to stay in the hospital for about a week, including at least 1 to 3 days in the Intensive Care Unit (ICU).
Recovery after valve surgery may take a long time, depending on how healthy you were before the operation. You will have to rest and limit your activities. Your doctor may want you to begin an exercise program or to join a cardiac rehabilitation program.
If you have an office job, you can usually go back to work in 4 to 6 weeks. Those who have more physically demanding jobs may need to wait longer.

You get a lot of literature when you're scheduled for heart surgery. We were both depressed and elated that much of it did not pertain to G-man. His diet was great, and, although it diminished with his blood flow, he exercised. He didn't smoke or drink. He was an anomaly as a heart patient: not there for poor health, and not there for being old. It was slightly encouraging, and with the surgery date rapidly approaching we took all the encouragement that came our way. We read, we partook of Humboldt's summertime food bounty, we played with the new dog. I submitted my FMLA paperwork (Family Medical Leave Act) to the post office. We shopped for a post-op chair.

That's right! For a month after the surgery G-man would have to sleep flat on his back, no rolling onto his side. He would also have a difficult time clambering into and out of our very-tall bed. We spent an hour after the Saturday farmer's market inside the Arcata Exchange, test-driving different lounge-chairs. We had been fore-warned that the pushing and pulling required to use an attached foot rest might be too much, so we got one with a detached ottoman, that was cushy enough without being too plush, and that most importantly, reclined almost completely flat.

What to Expect
The operation will be scheduled at a time that is best for you and your surgeon, except in urgent cases. Be sure to tell your surgeon and cardiologist about any changes in your health including symptoms of a cold or the flu. Any infection may affect your recovery.
Before surgery, you may have to have an electrocardiogram (ECG or EKG), blood tests, urine tests, and a chest x-ray to give your surgeon the latest information about your health.

The tests were our fore-shadowing. The x-rays, the blood tests, no problem. But Dr Postell also wanted a pair of tests to view the heart, as in, send down a camera. Now, the one where they thread a camera up to your heart through your femoral artery, yes that made sense. Of course you can reach the heart through an artery! Unpleasant, but doable. Did you know, though, that you can also reach the heart by sending a camera down the throat?

I'm still not clear on how that's even possible; frankly, my mind shuts off at the point when it gets too uncomfortable with what exactly was going on. And trying to suss that out is definitely one of those points. It was also an extremely uncomfortable procedure for G-man.

The morning of the surgery I drove us into Eureka, well before sunrise, and up to the emergency room of St Joe's, where we signed in then were whisked into pre-op. We sat together and tried to keep it light as he was scrubbed, enrobed, shaved, and tricked out in the latest cyborg fashion accessories. [The entire staff of St Joseph's, from orderlies emptying trash cans right on up to the ICU nurses, played along and humanized, as well as made tolerable, the intolerable. My sincere and undying thanks to them all.] Then they wheeled him away.

***

To be continued because I've had enough for one morning.--Suzanne