1995 ⚕️Heart Surgery

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My wife has a broken heart; and no I don't mean that I stepped on it, left her, or hurt her feelings; though I'm sure I've hurt her feelings a few times. No, literally her heart isn't quite right, or even close to right -- and it effects all of us.

Birth Defect

My wife was born with an anomalous left descending coronary artery. When she was a baby, she was blue (cyanotic) and they said she wouldn't make it to 6 months. She did, then a year, and so on. They wanted to operate, but the chances were less than 50/50 that she'd live back then; based on the complexity of the surgery and so on; so her Mom just kept waiting and waiting. Finally, at 14 they decided they couldn't wait anymore, she'd had a few heart attacks, and technology had grown so her chances were better; and so she had the surgery. They basically did a double bypass to get around the blood flow problems on her left side and replumb the thing.

Well, if it had been a failure, we wouldn't be married today - so you can guess that it went well enough. They even put her boobs back on straight; which I guess was a big concern for a 14-year-old. I know, I've checked - they look fine to me. She woke up even though she'd gone through Operating Room 8. For those that don't remember, there was a horror flick called Coma that came out right before her surgery, where patients checked in, but they didn't check out. And there was a whole thing with my wife and her Aunt about the surgery and OR-8 - and my wife actually got that room. But she woke up, and after that, she lived the life of a fairly ordinary latchkey kid, with some bad luck. Emergency appendectomy and stuff like that; but no major health concerns.

Round 2

Years after that, my wife and I met, dated, mated and got married; the usual order of things. Soon after we got married, she started having angina (chest pain); shooting pains in her left arm traveling up to her jaw, spasm in her chest that would drop her to the floor, and generally not-so-good stuff like that. She went in, and the ever-concerned doctors told her it was nothing. Women have a tougher time getting taken seriously about heart conditions and especially young women. She was telling them, "look at my chart", or "would you like to see my midline" (surgery scar from the first time). It took a while, but eventually, she convinced them to let her see a cardiologist. And the cardiologist ran a few tests; most of them lame, and not showing anything. But the pain persisted, and so did she.

Finally, they said, "alright" we'll run a catheter (angiogram); which is basically a thing they thread into your heart through the femoral artery (inner thigh), and then they shoot dye and trace it on a scope and see what's going on. As far as I can tell, it is the only test that has any real value; so it seems to be the one they are most reluctant to use. But it is a procedure, though numbing you up is the worst part. Who wants needles in their inner thigh? My wife's had like 14 of them over the years - so we're pros at them.

So they do this procedure, which I guess is annoying and interesting. They shoot this fluid directly into your heart, which you can feel all over your body as warmth or heat, and they can see what's going on. At the time, they say everything looks fine, and they send you home. They say that unless you die on the table, because they don't want to worry you; but you worry more because you learn you can't trust doctors. But that's another story.

Well, they don't send you immediately home; they first put a pressure bandage on your wound, and you have to lie flat on your back for hours while it heals. And they take it off to see how it is doing - and you shoot blood for 5' and spray the lights and the people if you aren't sealed when they checked. We know this, because this is what my wife did. That's a real gusher there. One of the drugs they gave my wife to thin out her blood for the procedure (to avoid throwing clots) metabolizes very, very, very slowly with her. Making the 4 hours into more like 6, and left a bruise the size of a fist. But none of that was the annoying part. I guess the hardest part was trying to pee into a bedpan, while lying flat on your back, with a male intern holding pressure on a bandage that's on your inner thigh. If she hadn't have been in such discomfort, it would have been outright amusing.

She got through that. And fortunately, the newer procedure (we've had a few of those) is to stitch the artery when the procedure is done - and it makes recovery happen in about 1/2 the time; still annoying, but not as annoying. But the worst part of the procedure for my wife has not been the procedure but having to get catheterized because she couldn't pee without it.

For many, they find little narrowing of the arteries, and so on - they just blow up a balloon to stretch it out - and they usually have a little metal stent to hold it open - and that's it (angiogram). They're out jogging the next day and feeling a little better. My wife didn't have a little narrowing. They'd told us things were fine. They lied. I guess they do that. They called us back in like a week later; and you just know that can't be good. They wanted to review the case. She was voted the "most interesting case" at some cardio-thoracic conference. That's good to know, and great for the Doctor who wants to get published; but not exactly what you're hoping for.

Her previous bypasses had sort of worn out. They'd done venous grafts from her leg. These are usually good for 10-20 years. She'd gone 14, and they were aneuryzing (expanding) like little balloons. This caused bad blood flow, and more than that they could pop. They were already the diameter of a finger. If they pop, then the blood equalizes on both sides of the heart and you bleed out into your chest cavity, and basically have a couple of minutes to live; max. So maybe we should schedule immediate surgery. Ya think?!?!?

Surgery

It's pretty traumatic as newlyweds to be going through that. And everyone keeps saying, "but you're so young" to her. Like that's supposed to make her feel better? The prep work is humiliating; nothing like having a nurse shave your asshole and entire body before you go in; my wife was none too fond of that little experience. I teased her about putting on some aftershave, and razor burns; she wasn't in a joking mood. Then they IV you and so on, and do all the stuff that is none too pleasant. Then you come in an say your goodbyes and so on; never knowing if you're going to see this person again. That's a tad past rough.

We had a little warning before the surgery (a couple of weeks), so my considerate wife wrote all these letters, which she gave everyone on the day of the surgery. Stuff like how much she loved everyone, and what they'd meant to her, and basic closure kind of stuff; cathartic for her, nerve-wracking for everyone else.

People can come to accept their own mortality often a lot easier than others can. And this sounds insensitive, but if you think it is hard for the patient, you should be on the outside. They go to sleep, and wake-up, or not. Outsiders have to wait, and wait, and wait - all while the clock slows down. And hospital time is already slow. I think the entire staff is on valium. Ask them for something stat, and they will slow motion respond, and it can take hours. I swear you can throw a ball into a hospital window, and watch it slow down mid-trajectory as it enters.

For my wife it was like a few hours of surgery, then some more. It wasn't scheduled to go that long, but they had complications; which makes it take much longer. They let us see her hours later in recovery; that's never a pretty scene. Someone with blood in their hair, tubes, and wires everywhere, and they're twitching and spasming on a respirator with their eye's taped shut and so on. Don't need to ever go through that again.

Then when you think you're past it, a few hours later they rushed her back in. Something had ruptured, and her heart wasn't sealed, and she'd gone through like 14 units of blood. So they fixed whatever was leaking. And 12 hours later she was looking much better. That one was close; too close.

They'd double bypassed her again but used a newer/better technique. They use mammarial arteries (that feed your chest bone) and feed them back to the heart. Since the bypass is artery (high-pressure hose) instead of a venous graft (low-pressure hose, with high-pressure blood), they tend to work better and last longer. That's good, because I like this wife (my only wife), and would like to keep her around. But they still harvested some veins, just in case they needed to do more than a double bypass. And they first tried to get some thigh veins from her right side - but all the angiograms or just her physiology meant that after fishing around a while, they gave up and went elsewhere. They'd already taken her left thigh veins at the early surgery (14), so they went lower left leg. Between that and some other surgeries, she's just a patchwork of scars.

So I'm there, talking to my recovering wife and the doctor comes in. And I had to ask, "what did you do with the veins, feed them to the cat?" It seemed like such a waste because they never used them. Inquiring minds wanted to know. I guess they had to harvest them ahead of time, because if they needed them and didn't have them, then it would be too late. He mumbled something about biohazard and so on, but didn't know how to take me. The nurse was already used to me. My wife was primping when she'd first woken up, and we were talking, and admiring the damage they'd done in a few hours; right leg, left leg, chest, stomach, neck, arms and so on; and she got to see the staples where they'd gutted her like a trout. And she still had tubes in her body and neck and looked very Borg. I just said, "ah, my little Franken-bride" when I saw her. The nurse was aghast at my insensitivity, my wife chuckled and would have laughed but it hurt way too much.

Recovery

It is a long road to recovery. Actually, they get you up and moving now much faster than they did a few years. And Beds are money, so the Hospitals are quick to get you out; both for your sake and theirs. But the body really doesn't like being splayed open like a dissected frog, and it tells you this with pain; pain in the chest, pain in the back (from having ribs stretched open), pain in the legs, and just general pain. It is so much pain and all over, that the brain can't compensate and there's usually post-op depression and mood swings that make PMS look like a sedate conversation with a detached therapist.

It is amazing how much damage is done by surgery and how fast you revert to completely incapacitated. Debilitating pain; even with drugs, has your brain sort of shut everything down. You can't move (it hurts), can't breathe well, and so on. You practically have to learn to do everything over again from scratch, but it comes back quickly. The second day it takes 20 minutes to get up, shuffle over to the bathroom (10' away) just to go pee. The next day you're walking up and down the hall; very geriatric. They give you a pillow to hug so that when you cough (weakly) you have something to hug and hold both for the pain, and so you don't blow sutures or innards across the room; though I gather it feels like both are likely to happen anyways.

But it is fast to jump into that hole and takes a while to climb slowly out. After a couple or few days, you muster the energy to take a shower; with a little help. She seemed all impressed that I shaved her legs for her - some pet peeve of hers that had to be done. But after getting clean, things seem to go quicker. A few days later she was released. And a few weeks later, she was able to drive and basically feeling human again.

Brother

My Wife isn't the only person that I know that had to go through this. My Brother as well had a similar experience. He was born with a hole in his heart; actually, there's a flap between the chambers that don't seal on a few lucky kids. Often it grows together, his didn't. It was kind of cool though; we could use a stethoscope, and listen to his heart, and it didn't beat like ordinary people - it sloshed around like mouthwash through your teeth. Squish-slosh.

So they had gutted him like a trout as well - back long before I knew Melissa. I was 8 when he was born, and he had to have surgery when he was almost 5. A similar deal I'm sure. My parents kept me away from the ordeal as much as possible. In general, I was able to cope with trauma much better than them - so I think it was as much for them as for me. Kids are pretty accepting; it is adults that often freak-out. My Dad and I built "Devon" (my brother) a train-set for when he got out. This made sense because my brother was never into trains, but my Dad was. My Dad still has a train room where he keeps Devon's train to this day; now it has like 4 levels and mountains, and like 30 engines and so on. Not to mention the garden train and so on. My brother gets to see it when he comes to visit - though I'm still not sure he gets to operate it unattended.

My brother healed quickly though - and bounced back like only kids can. He's been fine and lived an ordinary childhood.

Conclusion

My wife is more or less fine today. She still gets angina occasionally - and for a while, it was really bad. It took quite a while to get better though. Surgeons seem to wash their hands when they are done; literally and figuratively - the operation was a success, the patient is someone else's problem. The cardiologists tried - but they didn't really look at the whole case. They kept hitting her with different drugs or telling her that if things didn't get better they could replace her leaky valve or maybe a heart transplant.

I remember arguing with the Doctor; something I'm not likely to do. But the guy was talking about a transplant - and I mentioned, "what about Laser Perforation". He kind of does a double-take, and says, "well, um, uhh... that's pretty new and invasive, and how do you know about that?". My retort, "And a transplant isn't invasive?" He sort of looked like I slapped him, and I sort of had. Then I pointed out that UCLA was doing studies with perforation from the inside; using a catheter, and it was starting to show good results and was far less invasive, and that when you or your wife is going through such things, it is not hard to read up on what's going on and alternative treatments. After that, he was far less the condescending prick.

Surgeons often opt for surgery, and doctors opt for drugs. Later we went to the Cleveland Clinic, and the doctor took one look at her chart; gave a name to what she had (none of the others had), took her off most of the medications, and she's been doing much better. She has the blood pressure of a corpse, and one of the trippy little side-effects is that she has an enlarged heart and has always been thin. So she tells me, "here, feel my heart, it is beating funny". She puts my fingers between two ribs in her chest, and you can FEEL her heart. Not the beat - but the actual muscle pulsing just below the surface. That was freaky. Neat, but freaky. I told her to show that trick to her Doctor, which she did, and even he pulled his hand away startled and went, "oh, that's right near the surface, isn't it".

She also cracks me up. Other than a few party tricks and war wounds, she's generally been doing pretty well. People start whining about their traumas, and Melissa will sometimes do the scar comparison, or like an old soldier, tell her battle stories. Some older people will be talking about the bypass, and she'll just show them her midline - and they usually do a triple-take, "but you're so young". And because of the surgery, she didn't die young. As barbaric as some medical stuff is, it really has come a long way; and is usually better than the alternative.

Written: 2003.06.07