Wednesday, March 09, 2011

we can do this

For months I have been after her to see a doctor about the shortness of breath, the fatigue, and the heart fluttering she experienced whenever she would lie down. But Mary adamantly refused to admit that there might be something seriously wrong. She didn’t want to know. She figured if she just ignored it, it would go away. I finally convinced her, or more likely, she convinced herself, that it was time to let the doctor know about the problems she was having.

Mary is very much a take charge person. Type AAA personality. Always in control of everything in our lives. Because of that attitude she refuses to believe that she might be vulnerable to the common maladies that affect us mere mortals. As wife and mother, she is the ultimate caregiver, the rock on which our family is built. So to admit to herself that she might be in need of care herself was a major breakthrough.

So on Tuesday, two weeks ago, Mary saw our family doctor. After his examination of her, he scheduled the usual blood tests, an EKG, and arranged for her to have a stress test to determine if the symptoms she was experiencing were indicative of a heart problem of some sort. Mary followed through like a good patient and had the stress test the next day, Wednesday. On Friday our doctor summoned her back to his office to tell her what the stress test showed. Whenever your doctor tells you to come in to see him, you know there is something not quite right. So it was in this case.

The doctor told her that the stress test showed that there was a blockage in one of her arteries that was likely causing the problems she was having. He told her that he was going to make an appointment for her with a cardiologist to get his evaluation and treatment recommendation. The appointment was made for the following Tuesday. Not wasting any time.

The cardiologist studied the test results and after examining Mary and talking with her for few minutes, told her that a catheterization was in order to determine the extent of the blockage. He explained how he would insert a catheter into the artery in her groin and snake it up the artery to the blockage at her heart at which point he would either leave it as it was if the blockage wasn’t too severe (and treat it with medication) or he would install a stent. The stent would force the accumulated plaque deposits against the artery wall and remain in place to hold the artery open. He emphasized that it was a fairly simple and routine procedure that he had performed a couple thousand times without complications. Being such a minimally invasive procedure, he told her that she would be headed for home the same day after the catheterization was done. He made it sound so simple and routine, but when it is you who will be the patient with a catheter probing your artery near your heart it doesn’t sound quite so routine and simple. And again the cardiologist scheduled the procedure right away for Thursday morning. Like I said, not wasting any time.

On Thursday we had to be at the hospital at 5:30 AM so she could be prepped for the catheterization. Blood tests and medications and other tests were done and after a lot of waiting and a bit of sedation to calm her down and ease her worrying, Mary was finally rolled on her bed into the operating room. It took barely an hour to complete the procedure, but when the doctor came to find me he didn’t have good news to share. The catheterization showed two extensive (nearly 90%) blockages in the artery in such a position that a stent could not be inserted. The cardiologist explained to us that the next step would have to be a bypass. That is, open heart bypass surgery. This was getting more and more complicated. And scary.

The cardiologist then handed us off to the heart surgeon who stopped by around noon to discuss his involvement in this adventure. He explained how he would take the internal thoracic artery and graft it onto the left anterior descending coronary artery in such a way that the blockage would be bypassed and adequate bloodflow would be restored to the heart. Of course at this point all Mary heard was that her chest would be cut open. She was understandably frightened. And again she was scheduled to have the operation only three days later on Monday. Not wasting any time.

The weekend was one of dreaded anticipation and anxiety about what was coming up. Trying to get her to relax and not worry too much proved to be nearly impossible. Mary was convinced that she would have a heart attack at any moment. But she couldn’t just sit around worrying. Instead she got busy cleaning closets. Why closets and why now? Who knows how her mind works. I asked her why she was working so hard at such an unnecessary task and she said, “just in case.” She wasn’t ready to say just in case of what. I’m not sure she knew herself. But keeping busy over the weekend was probably a good idea despite her fear of that heart attack.

On Sunday evening she got a call from the anesthesiologist who would be handling her meds during the surgery the next day. That very reassuring phone call from that very caring doctor did so much to ease her mind and stop her worrying. Her whole attitude changed. She finally accepted what was going to happen and I think realized that this was the best thing she could do for herself. Mary finally came to understand that what she was going to go through was what she needed to live a full and active life again. The bypass surgery was a good thing. She slept fairly well Sunday night.

On Monday morning we arrived at the hospital around 8 AM to be prepped for the surgery scheduled for 11AM. The first person we encountered was that anesthesiologist who had called Mary the night before. He again reassured her that she was in good hands and would be well taken care of. Mary was in remarkably good spirits considering what she was about to go through, even joking and laughing with the staff of nurses and techs who were doing all the preliminary testing. The fact that she was not so nervous and apprehensive made it a lot easier for me to handle the situation. I hated the idea of her suffering and coping with the pain that was surely coming. I would gladly have taken her place and borne the pain and suffering for her.

They wheeled her away to the OR around 11:30. After giving her a hug and kiss and telling her how much I loved her and how proud I was of her for doing this, all I could do then was wait for the outcome. Waiting is most difficult when you have absolutely no control over what is happening. All you can do is banish, as best you can, all negative thoughts and doomsday scenarios that want to cloud your mind. Read, take a walk, read somemore, go to the cafeteria for something to eat, read a bit again, walk to stretch the cramps that come from sitting too long, then sit and wait again. I tried not to watch the clock hoping that that would make the time go faster. It didn’t.

Finally just before 3 o’clock the surgeon appeared to say that the operation went smoothly with no complications or problems and that Mary would be in the ICU shortly and that I could see her then. It was nearly an hour before I was allowed to see her, an hour spent frantically pacing and watching that damn clock. I just wanted to see her and touch her to make sure she was alright. When I finally got in to see her I was not at all alarmed to see all the lines and tubes that punctured her body. I wasn’t concerned about all the blinking lights on the monitors. All that was expected. All I wanted was to know that she was still my better half.

Naturally she was pretty groggy and mostly incoherent at that point, but she knew I was there and that was all I cared about. It hurt me so much to see her in all that pain. I wanted to be able to absorb the pain into myself to free her from it. She was in such obvious anguish and I could do nothing about it except to encourage the nurse to increase the pain meds to help Mary tolerate the agony she was suffering. All I could do was utter meaningless platitudes about how the pain would soon be gone as she started to heal. I can barely imagine what she must be feeling.

Now, here we are on the second day of recovery after the surgery. Mary was moved Tuesday morning (exactly two weeks from that first visit to our doctor) from the ICU to another hospital room for the remainder of her stay in the hospital. They already had her sitting up in a chair and walking a few steps. But the pain has barely abated at all. The Vicodin and morphine she is getting is not helping much. Still, the staff has her up and walking, using the bathroom, and eating. They seem to think she I doing well. And I suppose in comparison to other heart patients she is. But right now she is a long way from being the energetic and busy person we all know. The road to recovery is long and is just beginning. I want her back to normal. I want our lives back to normal. The struggle is still ahead. But we both keep saying that she will be better than ever once the pain goes away.

As Mary has often said when facing a difficult situation, “I can do this.” Yes, we can do this.

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