Wednesday, March 24, 2010
Getting to the heart of it all. . .
Although I've mentioned it in passing, I've never really blogged about my emergency open heart surgery on Sept 30, 2009 (coronary artery bypass graft or CABG surgery). Part of me is still in denial about the whole ordeal and how close to death I was that afternoon. How I can still be in denial is a mystery to me since I have a glaring reminder in the form of an 8 inch scar that runs from just below the base of my neck all the way down my chest to the top of my tummy. It makes that day sort of hard to forget.
The whole mess started in mid-September in the parking lot at work. It was a hot day and the air conditioner in my car was broken again. I had just stopped by Trader Joe's on my way to work to pick up some items. I bought several pounds of cheese, some grapes and a small bouquet of flowers to make the call center a little less institutional. My shopping tote was about is heavy as the giant Vera Bradley bag that always accompanies me to work. As I lifted the bags over the steering wheel to exit my car I felt a funny pain in my chest. Like a quick sharp cramp or what I thought at the time, a pulled muscle. I was hot, sweating and in pain for the long walk from my car to my desk.
By the time I sat down the pain was pretty intense but subsided after a few minutes of sitting quietly at my desk. I didn't think any more about it until a problem summoned me to a different department in another part of the building. While walking the pain returned. I thought it was odd - I wasn't lifting anything so why would the pain be back?
Each day for the next two days the pain hit only when my heart rate was raised. By day three the long walk to my desk from the parking lot had me in tears and I decided this might be more than a pulled muscle. I left work and drove myself to Banner Gateway's emergency room many miles away. It was closer to home than work and I rationalized that if I had to stay there at least I've heard that the food is good. Food. Always the priority. :-)
On the long drive I kept telling myself that it couldn't be my heart. I am fat but I work out regularly. I've lost over 40 lbs. I did 3 miles on the treadmill the other day with no pain at all. I walk 10,000 steps most days of the week. I was 44 years old - only old people have heart problems. Ah, so blissfully ignorant.
Much to my relief, the tests indicated it was not a heart attack, but the symptoms concerned the doctor enough so he wanted to keep me for three days of tests. The insurance company (they have the color Blue in their name) had other ideas and made the hospital release me after 24 hours and with only one out of three tests completed.
Over a week later I finished the treadmill and other tests at the office of my new doctor, a cardiologist. He wasn't happy with the results and decided that I needed a cardiac cath, short for cardiac catheterization where they insert catheters into your heart and arteries to check for problems like blockages. He said he thought I might have a blockage that would result in my being on special meds to clear it up or the worst case scenario, I may need a stent and I would need to spent the night at the hospital after they put it in. I was fine while talking to the doctor but completely lost it with the poor gals who were setting up my appointment. I'm a total control freak and this whole situation had just spiraled completely out of my hands.
The following week I was on the table at Banner Heart Hospital for my cardiac cath. I was to be awake for the procedure but I felt myself coming out of a fog listening to the doctor saying "Ninety Nine, it's NINETY NINE!" I was thinking "Great! Ninety nine percent unblocked! They'll just write me a prescription and sent me home." But actually - the opposite was true. My left ventricle was ninety nine percent blocked and my heart started to fail during the cardiac catheterization. The pain I had been experiencing? That was my poor heart being deprived of oxygen when I was active. The cardiologist was stunned that I was living with this kind of blockage for the last two weeks after getting kicked out of the hospital by my insurance company. My two doctors would tell me later that this kind of blockage at my age usually results in a heart attack that is quick and fatal.
I felt like my heart was beating in my stomach and it sort of was, since that is where the heart pump was located that was keeping me alive for the next hour until they could clean the operating room and bring in a surgeon. Of course, this information was presented to me in a much more delicate manner. They asked me which family members I wanted to speak to before my surgery. The way they worded the question was my first clue that this may not turn out so well. Funny though, I wasn't upset, not rattled in the least about being so close to death's door. Life has never been this out of control for me and yet - I was completely unfazed by the drama of it all. As a fat girl, all I could think about was the 10 lbs of boneless chicken breasts that I'd bought at Midwestern Meats the day before. I kept telling myself that I had to remind Ben to make sure they made it to the freezer. I got a great deal on them and didn't want them to go to waste. No matter what - it's always all about the food with me. :-)
They brought Ben into the cath lab and right off I informed him of the urgent need to get the chicken in the freezer. Even without my glasses on, I knew that look on his face. He thought I was nuts. The surgical staff probably chalked up my chicken obsession up to the IV I was getting. I was finally snapped back into the reality of it all when I felt a sharp pain in my leg. I looked down to see a very apologetic nurse with a needle and thread. She was sewing a tube down flat against my thigh. Now let's look back. . . I was a pretty calm child. I broke my collar bone when I was seven but I've never had stitches in my life. Still, I was pretty sure that there was supposed to be some kind of anesthesia or pain killer involved with this procedure. She said she was very sorry that she had to do this while I was still awake. Probably not was sorry as I was to have nurse Martha Stewart RN embroidering on my leg. All I could think of was WTF? They can't scrounge up a roll of tape to hold that tube in place?
My coronary artery bypass graft (CABG) surgery went well. I remember someone saying to me that they were giving me the same anesthesia that they gave to Michael Jackson. Uh, since we all know how that turned out why on earth are you telling me this? Geez, and I was still pissed about the lack of tape!
I woke six hours later as someone was explaining to Ben that they'd have me off the ventilator in another 15 minutes. "Like hell!" I thought to myself. "This thing is not comfortable and has got to go ASAP." I couldn't open my eyes or speak, but I knew Ben was close by. I started spelling the word "out" to Ben in sign language. Now, hindsight being 20/20 and all, it probably would have been a good idea to teach my husband the sign language alphabet at some point during our dozen years together. But noooooo. He thought my signing was just twitching. Great. Made mental note to buy sign languge book for hubby. On to Plan B - I started making scribbling motions with my hand to tell him I wanted to write. The other person in the room laughed and told Ben to let me try, but don't expect much. Sure enough, my handwriting looks like a doctor's scribble on a good day and being sedated for six hours didn't help it much. I still couldn't get my point across.
Finally the fifteen minutes passed and someone pulled out my breathing tube. "It's about f*cking time!" I croaked very loudly as the poor guy who was running the show jumped backwards at the sound of my potty mouth. I guess he didn't expect me to be quite so, uh, articulate. :-)
I spent the next day blissfully unaware that I was in CICU. Seriously, I just thought I had some really attentive nurses. Under my hideously ugly hospital gown I was wearing the biggest granny bra I'd ever seen. I chuckled at the though of the poor person who drew the short straw that day and had to get me into that thing.
The doctors, the surgeon and even the other members of the surgical team all stopped by with two questions. How are you feeling and did your husband get the chicken in the freezer? Thumbs up on both counts.
Two weeks prior, I could tell during my first encounter with all of my doctors that they thought I was lying about how much I exercise. Weighing more than 200 lbs sort of cuts into your credibility. However, after they saw the inside of my heart and arteries they knew I had to be telling the truth. Except for the area of the blockage, there was not even one percent of placque in my artieries or my heart. My valves were clean as a whistle. Their guess is that the overall good condition of the rest of my heart was what kept me alive during these two weeks after the initial pain. The said the blockage was probably a result of a piece of cholesterol sticking to a part of my artery where there was a slight bend. Everything else came around the bend and piled on top. They said it was a fluke thing but that I needed to change my eating, keep exercising and losing weight.
Post surgery went well and I tried to be a good patient to the awesome Banner Heart Hospital nursing staff. If they asked me to walk three times per day I would walk four times. I constantly blew in my little plastic gadget to make sure I didn't get pneumonia. I was motivated to get back to normal.
They discharged me on day six. This time by order of the doctor, not the Blue bean counters (who, btw, got to pick up the quarter of a million dollar tab for all this -LOL!). Two weeks after surgery I was able to log a mile per day on my pedometer. I got to skip cardiac rehab because as my cardiologist said, I would just embarrass the old folks by walking backwards on the treadmill and showing off. I was back working full time just 30 days after the surgery.
Now it's six months later and all is well. Unless I am wearing a scoop neck shirt that shows off my scar you wouldn't know anything happened to me. As a result of the surgery and due to my bad triglyceride genes, they've kept me on a statin, blood pressure meds, and a baby aspirin daily. My eating habits are still a struggle for me but I am making progress. My life depends on it.