SURVIVING SURGERY
This story is a chronology of my heart problems since childhood. The essay aims to educate others and me while continuing to seek out research and professional opinions relevant to millions of those suffering from heart problems.
I plan to engage in conversations on social media, including Facebook, Instagram, Medium, LinkedIn, and other social media sites, to facilitate a community of laymen, medical experts, and scientific researchers to participate in a grassroots effort to prolong and protect the quality of life. The goal is to save lives.
My health problems are congenital. I was born with a bicuspid aortic valve: two flaps instead of three flaps naturally implanted on the top opening of the aortic valve. The medical term is aortic stenosis.
The problem was evident as a child: I was short-winded and couldn't keep in sports and other physical activities because of cardio limitations. After puberty, the symptoms got worse. My heart rate was racing over 170 beats a minute while at rest. There was an intense pounding in my ears, and at times the pounding became so extreme it felt like a marching band was doing field practice in my chest.
My overly protective parents did everything to insulate me from the problem. They said it was a minor medical issue that was fixable. My family doctor also tended toward soft-soaping the problem. He would say it's nothing, don't worry - a couple of days in the hospital and you'll be fine.
My cardiologist hovered over my condition from three years old to young adulthood. He was part of a team that discovered the disease in children and completely understood all the underlying problems and the symptoms of aortic stenosis. His name was Doctor Downing, the chief of cardiology at Hahnemann Hospital in Philadelphia, PA.
He was a cut-to-the-chase kind of guy who didn't mince words. Without getting unnecessarily graphic, he explained the real deal when the time was closing in for surgery. They would open my chest cavity, stop my heart and place me on a heart-lung machine. The operation could take 5 to 7 hours. If the surgery went well, recovery would be three to six months.
Although his version of reality was scary and not as warm and fuzzy as the others, it was better to know what was about to happen. All that being so, the news put me on the edge of panic. It took all my will and mental strength to check my fears and anxiety. To maintain my sanity, I kept telling myself how wonderful it was to cheat death through the miracles of modern medicine. Had I been born 15 or 20 years before, I would have been looking at an early grave. How lucky could one guy get?
I began reading the German existentialists and Edgar Allen Poe to direct my mind into an apathetic space. What was life? According to writers like Kant, Nitsche, and Kieger Gard, it was an empty void with no meaning or purpose. If life had no intention, neither did death. Why be afraid of it? I knew it was all bullshit, but it did offer some comfort.
Dr. Downing was frail with tired eyes, pale skin from lack of sunlight, and overwork. He lived in a world of intense pressure and concerns, an authentic doctor who worried about the well-being of his patients. His life was taxing and soulfully painful life. The pain and stress molded his facial appearance and outward persona as cold and stoic, which couldn't have been further from the truth.
He had a short life, dying at forty-eight. The minister who delivered his eulogy did not forget to mention what a softhearted and sentimental man he was. That was a rare quality even for surgeons during my childhood. It is almost nonexistent in the current era. My father once saw him from afar, stroking his fingers through my hair and holding my hand to his face when I was lying unconscious in the ICU. These were not the actions of a stiff uncaring character - the burden of his compassion killed him.
When I started feeling pains and the constant pounding in my chest, I told my father, who rushed me to see Doctor Downing the following day. When the good doctor put his stethoscope on my chest, I could tell right away by the expression on his face and the look in his eye that I was in trouble. They ran me down to an x-ray, and when the results came back, it was determined my heart had grown to twice its average size. The doctor calmly told my parents he would arrange for surgery.
The surgery occurred at Deborah Hospital in Brownsville, NJ, near Fort Dix. You could hear the faint drum's roll and the soldier's march echoing through the pine barrens. It was 1972. Compared to medical practice today, the methods of heart surgery were primitive. However, It was the start of a new era in medicine - the beginning of what would evolve into an assembly-line style of heart surgery - that would later include many more medical procedures in the manner of Henry Ford.
The overall performance of surgeons, staff, and administrative oversight in this new frontier of medicine was in its infancy. People rarely speak of the consequences. It was when the brave and desperate, hoping for a longer life, died in honor of furthering science. If you had been there to witness those times, you would be remiss not to admit even though the efforts of the doctors and nurses were well-meaning and sincere; the logistical functionality could have been more cohesive and organized. But it was a new frontier, and new frontiers can get messy.
Most surgeons, nurses, and other staff members did their best to stay sane while navigating this new territory. As in all battles with intentions to improve the future, some people rise to the occasion while others fall to the waste side. Many doctors and nurses left Deborah because of the chaos.
When my time came, they performed a Commissurotomy on my aortic heart valve. The surgery aimed to remove scar tissue that had formed around the valve from years of abuse brought on by an abnormally high pulse rate. Cutting away the scar tissues increased the size of the valve, allowing substantial blood flow. I felt like Superman after the surgery, but to my misfortune, it was a short fix.
I woke up in the ICU to an extended regiment of torture custom designed for heart patients like myself. They sat me on the side of the bed every 15 minutes and had me inhale oxygen through a mask that looked like a hold-over from World War 1. A hose was attached to a green oxygen cylinder close to my leg. The lenses on the oxygen mask fogged as the nurses chanted to breathe deeper, as every breath drew me closer to passing out.
Though a river of painkillers and anesthetics streamed through my veins, the pain in my chest was extreme. After sucking in oxygen, they began rolling me back and forth on the mattress to keep water from entering the heart and lungs, causing congestive heart failure. That was an experience of pain I never knew existed.
Between those therapeutic sessions, I looked down at the rubber drainage- hoses implanted between my chest and stomach. They looked distended, like they were ready to explode. I called for the nurse. As soon as she saw the hoses, she knew I was hemorrhaging. She screamed codes and acronyms so loud people could hear them everywhere in the hospital. I was on so much dope it didn't bother me when she called a code blue. I was 19 and didn't know what code blue meant. I know now, and when I think back on her repeatedly calling it out in a panicked voice, it sends pangs through my stomach and brain.
The surgeon working on my heart failed to correctly sew back one of the sutures connecting to the main artery that connects to the aortic valve. It was like a runaway garden hose that broke loose and began shooting blood across my lungs and all other parts of the pulmonary area. They told me if the nurse hadn't caught it right then and there in the ICU, I would have died within minutes.
They put me on a gurney and hooked up blood to my IV. They rushed me back to surgery so quickly that the wind caressed my face, and it felt like I was riding on a motorcycle or the inside of a convertible car with its top down.
I went under for the second time. When the anesthesiologist hit me with the double dose lit my ass on fire.
It was at 2:30 in the morning. It must have been around 2:15 AM when they called my parents and woke them up to get permission to do a second surgery, leaving a 15-minute window for a battle between life and death. What if my parents hadn't answered? Would they have gone ahead with the second surgery or let me die? That question was left unanswered because I was too afraid to ask.
When I woke from the second surgery, I was lying on my back in a deep narrow bed with metal sides. It felt like I was in a baby's crib. I thought I had died and returned to the earth as an infant. That theory was dashed when a nurse came into the room, asked my name, checked my vitals, and hooked me up to a morphine drip. I lay in that same bed for what seemed like days, sick as a dog from the anesthesia and this horrendous pain in my chest from having it cracked open for the second time.
It took five days before I started coming around. They ran out of hospital beds, so they put me in the children's ward, which was empty except for me. The children's side was comforting and humiliating--making me feel like a baby. The good thing was I was away from the moans and groans of the other patients who had just undergone surgery.
Debbie, a beautiful hospital worker, was assigned to the children's section. She was a kind and gentle soul. We were both bored, stuck alone. The nurses placed me in a tiny child's bed. Debbie was happy when I arrived. She was thrilled to have a companion besides the nursing staff and others working the floor; there was nothing she couldn't do for me - did I need a softer pillow, another blanket, or about some snacks? She had a refrigerator full of them. We hit it off and launched into meaningful conversations as soon as my brain began coming out of the fog the anesthetic put it in.
We discussed the dilemma I had been through, then moved over to other topics. Debbie was five years my senior, but that didn't create a barrier in the hospital setting. I wanted to ask her once my stay was over, but I held out over fear of rejection and felt it would be wrong to take advantage of the situation. We tried not to advance toward one another, but I knew it was hard for each of us to keep things friendly.
I could tell she was attracted to me, and it was difficult for us to remain in a platonic relationship. For the rest of my hospital stay, I was obsessed with this beautiful and sweet girl gifted with the purest of souls God had to give. Her blue eyes, olive skin, and blonde hair that fell to her shoulders were intoxicating. I can still smell her.
There were many times when I wanted to ask her if she was in love with another guy. My instincts told me she wasn't. One night when we were up late talking and giggling, she told me about her recent breakup and that she was alone. I held back, even though I had fallen in with her, and she knew it. She could have lost her job fooling around with me, and we both knew that too. So I kept the fantasies I held for her to myself.
Aside from my pining for Debbie, everything went well after wrestling with the claws of death. I left the bed and spent the rest of my time talking to Debbie and watching TV on a thick padded rug for children to huddle around and listen to book readings.
There were times when Debbie and I would stay up late through the night talking, making it feel like we had become old friends. Debbie would bring me treats, books, and magazines to entertain me. She was in her last semester at nursing school, and the stint she was pulling at the hospital was her final practicum before she received her nursing certification.
About every six hours, the nurses would ask me if I could use a pain pill. (Of course, I could use a pain pill.) In those days, they gave you barbituates and handed me barbiturate capsules with blue and golden flakes hidden inside. They made me feel like I was sitting on a cloud high above the earth. No half-assed hydrocodone Percocet in those days; this was the real thing that not soothed your body and made you forget about the pain.
Debbie didn't come in until late afternoon. I spent time reading (The Narrative of Gordon Pym.) It was the only novel Edgar Allen Poe had ever written. The tale was filled with adventures about stowaways, shipwrecks, and cannibalism. The story was dense and rich with detail; I could only read it for a few hours. After finishing the book, I lay on the carpet before the television. There was nothing on the TV but news and soap operas. I had never watched them but soon found my medicated self engaged in them. There were "Day of Of Our Lives" and "General Hospital." I would watch them and cry. Someone was dying of a rare disease, on life-support, or seen jumping out of a window. It was real drama with real-life problems that could happen to anyone. It took me two days to learn who all the characters were, and I could easily follow the plot lines. After leaving the hospital and getting sober, I never watched another soap opera again.
On the day I left, Debbie and I exchanged phone numbers and promised each other we would keep in touch, but I never heard from her again. I still wonder what happened to her. She deserved a good life, and I hope she found one.
As I mentioned, the procedure at Deborah Hospital didn't fix the problem for long. I had that surgery when I was nineteen, and in my early twenties, I started to feel sick again. They did tests on me and said I was okay, but I was far from OK. There's a metric that heart specialists go by when determining the health of an aortic valve. You are in the danger zone if the opening goes below one centimeter. My space stayed about 1.6 centimeters for years, but I wasn't getting enough blood flow for my size and weight.
In 1992 I eloped and had my honeymoon in Las Vegas. My wife and I fell in love with the town. On the way to the airport, we looked at some model homes and bought one. We had no idea what we were going to do with it. At first, we figured on renting or making it a vacation home, which meant we couldn't rent it long term. My wife had a successful flower shop in Center City, Philadelphia. She was held up at gunpoint twice before we were married, and then it happened again. The robber put a gun to her head and told her to empty the register. Once he had the money, he said he would kill her. She had a gun on her but couldn't get to it. Someone walked through the door before he could pull the trigger, and he ran out. When she started coming around from the trauma, she looked at me and said we were moving to Las Vegas. We packed up my truck with all the belongings we could fit inside, took our dogs, and headed west, never looking back.
My heart kept getting worse. The cardiologist did tests on me and said I was fine; my opening was still at 1.6 centimeters. Then I caught this terrible virus that attached the heart valve. I called to see him. He was confused, having just run my tests. I told him I was in trouble, and he consented to rerun the tests. After running them, he came to me looking white as a sheet. He said he had never seen this happen before, but my opening was now .07 centimeters, and I would need immediate surgery.
The second surgery was at Cedars Sinai in LA. The surgeon's name was Doctor Kass. Initially, he would insert a metal valve, meaning you must stay on blood thinners for life. But, at the 11th hour, when I was lying on the surgery table, he told me about the Roth Procedure, where they configured your pulmonary valve into an aortic valve and replaced it with a cadaver valve. They were doing it in Europe, and the FDA recently approved it in the US. I went for it. I'm 70, and everything is still intact.
I had the Ross Procedure 1995. In 2008 an aneurysm showed up in my ascending aortic arch. I had to undergo another open-heart surgery to repair that. For some reason, that was a long recovery, probably because of my age. As far as the heart goes, I'm okay for now. I've undergone three open-heart surgeries and two back surgeries and am staring down the barrel of a third. Problems never cease. At least now, I'm still alive to tell the story.
