How to get bypassed
So yeah, I had the big bypass thing.
This all started in December, when I had an episode of syncope while down at the VA getting a hearing aid fitted. They sat me in a wheelchair and took my blood pressure at 70/40. That caused them to wheel my ass to the ER, where they took an EKG and noted some changes from my previous one about a year prior. That got me admitted for an angiogram.
The angiogram didn’t last long- they noted that I had multiple blockages of 80–90% and stents were not going to be an option. I was basically a walking coronary looking for a place to happen.They sent the VA’s resident cardiac surgeon to look at me. This asshole stood in the middle of my room and announced to my wife and I that he wasn’t going to do anything because “I don’t get good results from dialysis patients”.
In other words, “Go away and die so you don’t fuck up my numbers.” I told him to “get the fuck away from me” if he wasn’t going to help. If I could have gotten out of bed, I might have punched him.
The cardiology team at the VA had different ideas. One of the cardiologists asked me for permission to present my case to a weekly conference they have among the hospitals to see what other ideas/treatments might be indicated. A couple of weeks passed.
After Christmas, I got a call to set up an appointment with a cardiac surgeon at Methodist hospital. Part of the IU Health system, it is the hospital to which injured race drivers from the Indy 500 track are airlifted. The VA had contracted me out to the best hospital in town. Hallelujah!
I met with the Methodist surgeons in January. Tests followed. Late February, we picked a date for the surgery. March 17th. I was terrified, especially after they gave me the warnings and percentages, etc. For the first time in my life, there was a quantifiable, if small, chance that I was not going to wake up. I waffled a lot, not having a whole lot of experience with truly existential things.
The surgeon, Dr. Saila Pillai and her PA, Olivia Hamilton, helped tremendously, especially Dr. Pillai- her quiet confidence helped me drum up the courage to go through with it. I mentioned the awe and fear I felt at the idea of having my heart stopped and she just shrugged and said “That’s what I do” in a manner that suggested it was really not a Big Deal at all. Easy for her to say.
In the course of a few sleepless nights, I began to realize that I had the easiest part to play in the surgical suite. I would go to sleep, and then it was a binary proposition: I was either going to wake up, or not. If not, I’d never know.
March 17th 0530
We showed up at the hospital and got checked in. I did the undressing thing, and then a nurse came in and shaved my chest, leg, and chin/neck area to prep me for the surgery. Too quickly, and before I really felt ready, I was wheeled into a cold OR. I looked to my left, and there was a woman assembling things onto what I assumed was a bypass machine. Next up, the anesthesiologist said something like “Here, this will relax you” as he put a mask on me.
FADE TO BLACK
March 17th 1800
I wake up. Yay!
I am intubated and can’t speak. Boo!
Oh, shit, I hurt!
Someone finally notices I am awake, and suctions some gunk out, tells be to follow his finger with my eyes, squeeze his hand, wiggle my toes, etc. Passing all these tests gets the tube pulled out of my gullet. My wife shows up. “You’re in the ICU, you did fine in the surgery, they didn’t replace the valve, it was fine.” That was a lot to process right there, right then.
I think I spent about 2 days in the ICU, but I did remember to flash a friend of mine who happens to be a funeral director a high sign for the camera.
The next day, a couple of husky guys helped sit me up in a chair for about a half an hour. It was quite the production considering I had tubes coming out of my chest (3 each), my neck and my leg, plus a catheter. (Not that I really remember most of it)
On day 3, they pulled the chest tubes, removed the neck and leg tubes, and pulled out some electrodes that they had left in my chest to monitor my heartbeat, then shipped me off to a regular room. Finally, real food! (Of a sort- the menu was pretty limited.) The next few days were sit up, stand up, walk a bit, sleep a lot, punctuated by the novelty of receiving my very first blood transfusion ever to bring up my blood oxygenation. I did learn that my limit on Percocet is, basically, one. I took two once and spent the next four hours as a motionless zombie. They noted it on the chart in the room — “Do not give this patient Percocet”. Also, a new rule- don’t give me narcotics and a cell phone: I’ll start calling people with abandon. Friends don’t let friends phone drugged.
I have to say that by this point, I felt a bit of limerence for Dr. Pillai, simply for her gentle and sensitive way of waking me up. She’d come into the room, and just take my hand in hers, waiting quietly until I’d wake up to her smiling face. It worked every time.
I also learned some more hospital cant- I was a “Cabbage times 4”. CABG — Coronary Artery Bypass Graft — hence “Cabbage”. The rest of us mere mortals call it a quad bypass.
A week after the surgery, the hospital released me to “rehab”. An ambulance came to pick me up and transfer me from the hospital to the rehab center.
“Rehab” was pure hell. I was placed in a center near my home that was rated pretty good……by whom, I have no idea. This place has been around, I’d guess, since the 1960’s, judging by the amenities and architecture. Not one bit of soundproofing in the place. This became important.
My introduction to the routine came on the first morning at 0500, when I was woken up by the Night Nurse to give me eye drops. The method of waking was to turn on the light and hold me down while prying my eyes open and administering generous doses of drops in each eye. I started struggling instinctively, and eventually managed to yelp “What The Fuck?”
This produced a stern warning from Night Nurse: “You watch your language here- I don’t have to take that from you!”
“Why are you giving me eye drops?” “It’s for your glaucoma”, she announced, in a voice that could carry to Cleveland. “I don’t think those are mine! I don’t have glaucoma!” I yelled. “Don’t you understand you have glaucoma?” she asserted again, in the voice that probably was heard in St Louis.
Understand that I have just been through two cataract surgeries in the past year, and I imagine that if I’d had glaucoma, just maybe once in the long series of appointments and follow ups, one of the ophthalmologists or surgeons just might have, once, mentioned that I had glaucoma if that was so. I was pretty confident that she was fucking up, and wasn’t an ophthalmological resident in her spare time.
It didn’t take long for me to despise the place (“Golden Living Centers”, indeed!). Night Nurse was the worst, roaming the halls all night with all the subtlety of a Peterbilt 379 Tri-axle dump truck, with a voice to match. When she wasn’t around, I started identifying my neighbors. There was Moaning Myrtle across the hall (Like to hazard a guess as to what she did all night?), and Howling Harry next door, with whom I shared a connecting bathroom. There was nary a shred of soundproofing in the entire place, from the hardwood floors and the thin-panel doors, to the painted ceilings, and the door to my room was broken and wouldn’t close.
And the food! Prison food was the best simile I could come up with. Bland food with no seasoning, and coffee that could best be measured in thimblefuls in a paper cup, served by a completely indifferent, sullen staff who didn’t bother more often than not to make sure the right meal got to the right patient, or even to see of they got a meal at all.. Things progressed unchanged throughout the first (Holiday! It was Easter.) weekend. No physical therapy, no change in the diet, no abatement in the behavior of the other denizens. I heard every instruction and snide comment from Night Nurse, all night every night. After three days of this I was completely sleep deprived, miserable, and in tears. The next fun thing was the bus that took me to the VA dialysis center on Tuesday. The trip down wasn’t too bad, it was just me in the bus. When the driver picked me up in the afternoon, he had the bus loaded with about 20 octogenarians and left me to be strapped in my wheelchair in the very back.
Did you know that “Jesus loves me this I know” has more than four verses? As does “If you’re happy and you know it clap your hands”? Now, imagine me, a rabid atheist strapped in a wheelchair in the back of a bus with a score of octogenarians on their way back from their weekly (I shit you not!) visit to the Golden Corral Buffet, all the while singing Kindergarten bible school songs. Every time the song got to “Clap Your Hands” the bus driver would take his hands of the wheel and clap along. At 70 mph. On I-70. At rush hour.
If I had had a pistol I would have shot myself right then and there.
It so happened that the following day they had some kind of “Care Management meeting” for me. I let them have it with both barrels and the machine gun as well. I sat there and detailed every stinking shortcoming of their facility in gruesome detail, mentioning that Night Nurse was a walking HIPPA lawsuit, the bus driver was a hazard to life and limb, and it wasn’t very conducive to having a restful recuperation if one can’t get even one hour of uninterrupted sleep or a decent healthful meal. I walked around the room like a caged lion and essentially let them know that the only thing I wanted from them was my walking papers RIGHT FUCKING NOW.
They hastened my ass right outta there, loaded me up with most of my prescriptions, and my dear wife took me home to my own sweet bed, where I really began my recovery.
A word about recovery- I ended up taking Norcos for the first month to be able to sleep, but other than that nothing for pain. The full course is about six months to get the sternum to knit properly. Also, since they spread my chest apart about six inches, every place where my ribs join to something else is bruised or whatever, so, yes, some pretty general aches and pains. (Right now my sternum is held together with surgical steel staples.) I’ll write more as my recovery warrants.
In closing, I’d like to say thanks to all the people who supported me and kept me in their thoughts during what has been a difficult time for me. That’s one of the things that’s helped a lot- just knowing that so many of you cared.