Surgery Successful

Well, what happened? I know you’re anxious, so here’s the results of my surgery, in a nutshell: successful. Prognosis? Positive, cautiously, though, as usual. Let’s wait and see, but we’re very, very pleased with how the procedure went.

I’ll take it.

Want some more detail? Okay, since I’m in a mood to write. Here it is:

Wednesday morning I woke up at 5, after six hours of sleep, tossed and turned for a bit, then went down to the kitchen for a small bowl of cereal (the hospital said I could have a light breakfast as long as it was before 6 am). I made the baby’s bottle, and my wife fed her. I dropped little Patch off at the sitters and drove back home in silence. I said a Divine Mercy on my Rosary, and studied myself at that moment. I was calmer than I had been the past few days. Relaxed for the most part, and in a good mood. Probably because the waiting game would soon be over, and that sword hanging over me by a thread would be taken down and put back over the mantel.

Once home, I showered and dressed, aware of the ticking clock. My wife was ready, and we left around 9:30 to drop off our other car at a relative’s house in case it would be needed to pick up Patch at the sitter’s later in the day. We took the George Washington Bridge into New York and got in surprisingly quickly, in something like twenty minutes or so. Columbia Presbyterian is only a few minutes from the bridge; we found parking and I gathered up my bag and walked to the hospital entrance a block away. It was up a fairly steep hill for NYC and with the humidity I found myself really winded by the time we reached the reception area.

Check-in and Pre-registration was cordial though the waiting room was packed. An Asian gentleman got into a verbal altercation with one of the three Hispanic receptionists while those of us waiting in the chairs exchanged nervous smiles and rolled our eyes. The View was on the television set above me, though it might have been a video feed from a barn filled with mooing cows for all I cared. A half-hour went by (we were early), and I wandered off to find a bathroom. When I got back a small, extremely friendly man greeted me by name and told me to follow him.

They took me to the prep room, gave me instructions, and pulled the curtain closed. I was by myself, and suddenly seemed so alone. For a moment I kept thinking, “Not again … not again …” I undressed and put on the hospital gown and tied it around. It was freezing in that room – maybe as cold as sixty degrees? Colder? A physician’s assistant came in to take down the labyrinth of my history. A nurse followed and took my vitals and an EKG. Another started an IV. Finally, my wife was allowed in. I was in good spirits, and made several side-splitting jokes, which would be in very poor taste repeated here. My wife shook her head in disbelief, how I could be moody and grumpy days earlier and so light-hearted minutes before surgery. Gallows humor, I said.

My surgeon came in and chatted with us for about ten minutes. He was highly optimistic, the sort of guy who wears his heart on his sleeve. However, he also started speaking quickly of alternative options should this procedure not work out – things such as open-heart surgery. I wish he didn’t go there, at least not until we had to. I think he sensed this from me, because he suddenly waved his hand and said, “Oh, this is just me thinking three steps ahead.” He left upbeat and cheerful.

They wheeled me away about 1:45 in the afternoon, into the room where the procedure would happen. Two men started prepping me, both of them very funny and downright goofy. It was infectious; I told them that at this point I was so used to doing these catheter procedures that I thought about shaving myself when I showered earlier but decided against it. “As long as you don’t have a problem with another grown man shaving your groin,” he said, laughing.

The anesthesiologist, an Asian woman, came in and set up her station. There seemed to be some concern about finding certain things, but, once she saw me watching her, she explained that this wasn’t their usual room. A fourth person came over and my shaving friend introduced him as Osama-so-and-so. “He’s going to assist your doctor with the catheter insertion.” Seeing my expression, he continued: “I know you don’t know whether to believe anything I say, but his name really is Osama.”

Osama grinned and swabbed some ice-cold blue antiseptic over my groin, abdomen, and thighs. Then he covered me with some adhesive padding. I think. I’m lying on my back, staring straight up and can only see these things peripherally. One thing I like to do in these situations (this is my ninth surgical procedure in three years, the sixth in the past five months) is observe the tile patterns in the ceilings. Often I can find the shape of the cross which best fits the proportions I would imagine the true Cross to be, and I try to remain fixated on it.

After fifteen minutes of being prepped, the anesthesiologist put a mask over my face and gave me some oxygen. A few minutes later she said, “Here’s that cocktail I promised you.” Maybe thirty seconds after that a relaxed wooziness fell over me. “How are you doing?” she asked. “I feel like I’ve had one drink too many.” “That’s how we want you to feel.”

I knew I was going under very soon so I kept mentally repeating, “Lord Jesus Christ, son of God, have mercy on me, a sinner,” over and over and over, and then, disconnect –

My doctor was talking to me out of a fog. “It went very well! We got it open, on the first try!” He said other things, but I don’t remember exactly what. Others were cleaning me up, covering me with warm blankets. I was placed back on the gurney. “Did I talk in my sleep?” I asked the anesthesiologist. “No,” she said, a voice with no body, “were you dreaming?” I thought a moment, trying to capture distant, fading images. “I dreamed I was talking to people in the desert.” Actually, it was a desolate landscape, like the moon, but with obviously breathable air, but I could only vocalize the word “desert.”

They wheeled me out to the recovery room, where my wife was waiting for me. The procedure took about three-and-a-half or four hours, so it was now close to six o’clock. Relatively quickly I was lucid. She told me that the doctor brought her in to the “control room” where she could see the before and after pictures of my pulmonary vein. The before pictures showed a spindly vein about the apparent size of a telephone cord; the after showed a wide-open vein the comparable thickness of a tree trunk. She was very pleased, very happy, and told me that the doctor felt the surgery went almost better than expected.

She left to get my father-in-law, who generously drove two hours up from the Jersey shore to fight NYC traffic to be here. While I was under they went out and got coffee, and he also joined my wife in that control room. He remarked that as I was coming up I went into convulsions, but a nurse pulled the blinds down over the window to the OR before my wife could see it. Of course I felt nothing.

The problem I was having has to do with the two pulmonary veins connecting my heart to my left lung. Due to complications from my heart ablation done in March of 2008, scar tissue forming around the ends of the veins are causing them to close up. I would get very tired very early in the day; going up a flight of stairs presented quite a challenge, and I’m still a fairly young guy. The real danger is that blood cannot drain from the lung; ultimately, if both veins close, the lung will have to be removed. The smaller vein had already closed up. The larger vein had shrunk to one millimeter thickness, down from about ten. In February, doctors at another hospital had ballooned the vein from one millimeter up to six. But at the end of May I learned that the vein had again collapsed back down to one millimeter.

The options I faced were to either balloon it open again, or put a stent in. Ballooning it open again faced two risks: first, the vein could rupture, and second, there was no guarantee I wouldn’t be facing the same situation again in another three months. My other doctors were kinda scratching their heads over the whole thing, so after a consultation with my cousin’s heart surgeon at Columbia Presbyterian, we decided to go with the stent procedure. A stent would have the best chance to keep this vein open and the blood flowing through it.

A nurse’s aide who apparently had just recently jumped from a plane wheeled me up to my room. Every person he passed he promised and / or threatened to take up with him on the next parachute jump. I had a male nurse, Kevin, who helped me into my room. My wife was with me and remained to make sure I got comfortable and got some food: a turkey sandwich and some orange juice, which burned my throat, sore from the breathing tube that was down it. She left after twenty minutes or so, to get our youngest, Patch, from my aunt and uncle’s, who picked the littlest one up from the sitter earlier in the day.

My first instinct was to sleep, but Columbia Presbyterian would not allow it. My blood pressure was taken, first every fifteen minutes, then every half-hour, then every hour. Blood work was done around 10, then a chest X-ray was taken an hour later. The hospital has these flat-screen TVs on adjustable arms that come out from the wall behind the beds; I channel surfed during all this but I don’t remember what shows I watched. I do recall The Outlaw Josey Wales was one, which was remarkable because I watched it the last night I was in the hospital back in February. What’re the odds? Anyway, I had a nagging pain just behind my eyes, so they gave me Tylenol. Other than that, I was drug free.

Unfortunately, I shared a room with an older Spanish gentilhombre who spoke no English. I took a couple years of Spanish in high school and worked with Spanish-speaking people for years, so I could understand enough to know he was not a happy camper. Apparently his blood pressure was through the roof and nothing the hospital could do or give him could alleviate his splitting headache. It just came on him suddenly after they changed his IV drip, but the nurses and doctors insisted that that had nothing to do with his high blood pressure. Anyway, it made for an almost-sleepless night for me. I would nap for a half-hour here, forty-five minutes there. Once I cried out, very loud. Another time, I had a dream I was vomiting up copious amounts of thick gravy-like stuff. It wouldn’t stop. I woke myself up, disoriented, aware I was in a hospital but not sure why, wondering if the vomiting was why I was in there. But that faded quickly, and I turned back to the TV.

My doctor visited me promptly at 8 am, joyous and perky as always, asking me how I felt. He said I could get out as early as noon, after another X-ray (the one they took last night looked great) and a lung scan. I asked questions, made sure I understood what had happened the day before, and asked him what the next steps were: a follow-up in a couple of weeks, then we’ll see what’s next. He left, and I called my wife. After that, I got up on my feet for the first time and relieved myself of a quite full bladder in the bathroom.

A second X-ray, then the waiting game. I read forty pages of my Medieval Philosophy book, finally able to concentrate now that my headache was gone and my roommate was asleep. I watched some TV, saw that Farrah Fawcett succumbed to her cancer. Walked out in the hallway, admired the view of the Hudson River and the George Washington Bridge from a couch by a window. A physician’s assistant gave me a prescription for Plavix, an anticoagulant to prevent clots from forming around the stent. Oh yay. Washed my face and brushed my teeth.

Around 1 o’clock I was taken down in a wheelchair to Nuclear Medicine. This was for the lung scan. It was my third go with this delightful test (the other two at two other hospitals in February). A lung or VQ scan is a mildly unpleasant test to see the profusion of blood in your lungs. An airtight mask is put over your face and you breath in radioactive Xenon gas for eight minutes. It’s uncomfortably warm and you feel a mild sense of suffocation. Then, they leave you on your back for fifteen minutes, long enough for the radioactivity to seemingly saturate every cell in your body. A nurse comes in and injects that metallic-tasting contrast dye into your IV, and you’re slid into a rotating MRI-like device. What results is an image showing where exactly the blood is flowing in your lungs. The whole thing took a little over an hour, then I was wheeled back up to my room.

My roommate was packed, apparently healed of his superhypertension. “Buena suerte,” I said to him, and he winked on the way out. The physician’s aide came in and said I could dress and go home. I did, then called my wife, who, luckily, was working a store in Yonkers. I signed the release paperwork and after waiting unsuccessfully for a wheelchair, decided to walk myself to the elevators, down the admitting area. My wife drove up earlier than expected, and in about ten minutes we were over the bridge and heading for home.

We got our little apache warrior from the sitter and then got burritos to celebrate – vegetarian, of course. My wife dropped off my Plavix prescription at the drug store, then we got home and had dinner to the shocking sudden news of the death of Michael Jackson. My wife fed and put down the littlest one. I was also out of it, really feeling the need to sleep, but managed to take in two episodes of the funniest show on TV, The Office. Then, I passed out in bed, a little after 9, and didn’t wake up until a little after 7.

Quite an adventure, and hopefully the last for a very, very long time.