Friday, December 7, 2007

My heart

I’m delighted to report that I’m alive and well. We weren’t entirely sure it was going to work out that way these last few days.

The exercise chest pain we had been discussing these last few weeks was not the result of California smog. It was not indigestion. It really was an early warning of heart trouble. There had been a gradual drop off in exercise performance, but the chest pain defined it. Restricted blood flow to the arteries in the heart. The chest hurt when the heart couldn’t get enough blood to do its work. As the arterial restriction increased, the exercise capacity decreased. We went to the doctor.

We couldn’t have been better cared for. The GP doctor in Port Aransas called the cardiologist directly to get us right in. The cardiologist gave me the treadmill test himself (not to see how far I could go this time, but to document when the discomfort started). The cardiologist got us a room in the hospital that night and on the calendar for the “cath lab” the very next day. The cath lab found an artery that was 99% blocked, closely followed by two more blocks at 85% each, and another artery that was 70% blocked. We had made it to help in time, but just barely. They opened up the blocked arteries and put in a couple stents to make sure they stayed open. One day later I’m home and good to go. Good as new…. or at least better than before… writing this!

What an amazing process! They puncture an artery in my leg, feed instruments all the way up into my heart (angiogram), identify the blockages, open them up with a small balloon (angioplasty), insert little wire mesh cages (the stents) into the affected areas, expand another balloon inside each of the stents until they match the diameter and configuration of the arteries, pull everything back out, and send me home within twenty-four hours of starting the procedure. I never got a general anesthetic; it was all local. I never even got a pain pill. I never needed it.

In the hospital, they kept good track of me. Before and after the procedure, I had a heart monitor on my chest at all times. All the wires attached to my chest terminated in a sending unit in a pocket of my gown. The nurse’s station was monitoring the signal from every heart monitor on the floor. The morning of the heart catheterization, Judy got next to me in bed for an extended hug. Within just a few minutes, the door burst open and the floor nurse said “I have to see his heart monitor.” He checked everything out, then pushed a button to turn the heart monitor back on. When Judy laid up against me, she unknowingly pushed the button to turn the heart monitor off. All they could tell at the nurses station was that I had suddenly flatlined.

It was a long day Thursday. We were up at five for the blood draw, vitals signs, and such. A few hours later they took me into the lab for the procedure which took a couple hours, then held me in recovery for three hours, then sent me back to my room with instruction not to move my right leg or anything attached to it, and not to lift my head for six hours. They had just punched a hole in the femoral artery in my right leg through which to thread the instruments up to my heart, and they wanted to give the artery time to close back over before we did anything that might accidentally open it back up. It’s an artery, not a vein, so we really really don’t want that thing pumping uncontrolled. So I’m lying on my back in bed. I can’t move anything on my right side. If I forget and bend my left elbow, it crimps off the IV line and the alarm goes off on the machine next to the left side of my head, so I can’t move my left arm much either. Halfway into the six hour don’t-move-a-thing assignment, it had been ten hours since the last time I peed. We asked the nurse if it was okay for me to get up for a minute. She handed me a bottle. Right. I’m going to lie on my back, head on my pillow, not clench any muscles, and pee into a bottle. Sixty years of training to hold the bladder while in that position, no matter what, no matter how many times you dream about walking into the restroom and peeing; and I’m going to convince all my involuntary muscles to forget about that, it’s okay to go just this one time. It was a long three more hours to the end of my bed rest sentence.

Early on in this process, as I lay in a room between visits and tests, Judy and I together at all times, I was struck with the realization that had I been born at any other time in all of human history, we would be saying goodbye right now instead of choosing treatment options. I was fading fast. I could feel I only had a short time left. Without the option of going inside the heart and fixing it, there was nothing else to be done. My time had come.

It’s a good time to be alive.