Strange Rhythms. (Part 4)
I’m on the other side now.
Thursday was my transesophageal echocardiogram (TEE), a scan performed to check for blood clots in my heart prior to surgery, to make sure nothing can get dislodged by a catheter and cause a stroke. If you have a strong fear of choking or things in your throat, which fortunately I’m not too bad at, this one would be a nightmare. I kept telling myself it was practice for sword swallowing. The morning starts with the usual four attempts to get an IV started, the doctor becoming impatient as he keeps returning to find the nurse still struggling. My arm is a bloody mess by the time we have a line going. They’re in a hurry, the blood can wait. In comes the echocardiograph machine with the same operator I remember from a few weeks ago; she remembers me because of my tattoos and expresses hope that I’m not in here because of something she found inside me.
I was under the impression that the TEE was performed with a skinny wire and did a double-take when I saw a two foot long flexible black probe about as thick as my pointer finger. The tech met my look with a shrug and slight smirk. This is probably the part where a lot of people try to run away. I was given a cupful of lidocaine jelly to let sit at the back of my throat and gargle and swallow, followed by a few sprays of another topical anesthesia. Instant panic. Along with not being able to feel whether or not I could swallow, it started to become difficult to feel my own breathing.
And then a shot of sedative in my IV. Whatever it was, it was good. All the fear instantly subsided. I see how people go off the deep end on medical grade drugs. And then another shot. Even better. I melted into the gurney, feeling more relaxed than…ever? Alarm bells should have been going off when a plastic tube and mask were strapped onto my face to hold my mouth open and prevent me from biting down. But I was just too comfortable. When the probe was in the back of my throat they told me to swallow, creating a brief opening so it could be forced down. Once down in my esophagus behind my sternum it was a pretty strange and uncomfortable sensation; literally that of hard metal and plastic rubbing around somewhere deep in my chest. As they flexed and rotated it while scanning my heart I lay there passively in my drug-induced haze, surprisingly not worried about what was being done to me, though it was uncomfortable. An entire life could go by and it wouldn’t bother you in that state. Thirty minutes later the scan was finished and the probe was pulled out with one swift, horrible tug. I was cleared for surgery and they began prepping me for the next morning; some final bloodwork and getting shaved from knees to chest. I was discharged with an incredibly hoarse and raw throat, getting worse as the drugs wore off and the day wore on.
The night before surgery went by in a blur. I did a fairly good job of not thinking about it. The drive to the hospital at 6AM the next day felt a little like a trip to the gallows, filled with complete uncertainty as to what was going to happen. It’s the waiting that makes you crazy. While I stood in line to check in, it was difficult looking at my wife, mother, and sister sitting in the waiting room together. These are my people, the ones that pull together. I couldn’t help feel that while they were obviously there for me, I wouldn’t know it when I was out. They were just as much there for each other and it was good to see them together. Other families filed in, probably five in all, forming little units units of kinship throughout the room. I couldn’t help but notice that all of the patients were men.
One by one, nurses filed in to call respective patients and lead them off to be prepped. Deep breaths, hugs, tears welling behind eyes. Soon it was my turn, led down a hall and to my gurney. Undressing, starting IVs, meeting my nurses, anesthesiologist, my surgeon. I’m told about the procedure, that my surgeon is now opting for cryo-ablation, a process whereby instead of using heat, cold balloons will be inflated around the openings of my pulmonary veins in the left atrium. The extreme cold will destroy any bad electricity, isolating the veins and the bad signals they are producing. It is supposed to carry slightly less risk than using heat. I’m then dutifully reminded of what those risks are, informed that there is a possibility I could end up in open-heart surgery, or worse, due to certain complications. At this point there’s nothing left to do but agree and move on.
Family was let in for a last goodbye. Everything said tends to feel like it falls a little short. There’s not enough that can be said or done by any of us. We can only try. They can’t go down that hall with me so they turn to each other. I make the walk with my head up, escorted by a nurse and anesthesiologist. It’s all-in at this point and I’m feeling alert but not nervous. All I can do is what I’m told.
The surgery room is like the command center of a space station. A bank of a dozen monitors hover over the table in the center. The table is also part machine, a massive rectangular block covered in knobs and controls, likely those to be used to guide the catheters and probes inside me. Machinery, wires, hoses, computers, and tools are everywhere. Drugs that will induce arrhythmia so they can focus in on the electrical sources. The ceiling is covered in cameras and scanning devices. And the system begins to roll, inertia quickly building, orders and confirmations flowing between the staff. My surgeon is getting dressed in the back as nurses and techs hurry in circles around me. Electrodes, patches, IVs…I’m being synced with the machines that surround me, every facet of my physical existence being measured and displayed on a screen. I hear the surgeon beginning an audio recording in the corner with my name and the time and date as nurses begin propping up my arms and padding and securing my head. The anesthesiologist puts an oxygen mask on me and tells me to take a few deep breaths and that if I feel sleepy, to just go with it and keep breathing. Here we go. By my third breath I’m gone.
I was in surgery for seven hours.
Or more precisely, my body was in surgery for seven hours. I don’t know where I was. I am convinced that this is what death is, only without waking and remembering that place of nothingness.
But I do eventually awaken. Images are fading in and out slowly. A nurse talking to me. Lights. Then Lusi and my mother and sister, the curtains of the recovery room. I’m incredibly disoriented and feel like I need to throw up. I here someone very far away tell me the surgery went very well, a vague image of my surgeon standing there, and blackness again. I remember saying goodbye to my mother and sister, more blackness. I start coming to in another area, still fighting nausea. Slowly things start to become more clear. Lusi is beside me. I’m told again that everything went well and the surgeon is very happy with the results, that he believes he wiped out all the bad pathways. I start to become aware of a nagging pain in my chest, pressure, and a feeling of tightness. There is a heavy sandbag on my groin, applying pressure to the catheter sites. Three incisions were made on the left, one larger one on the right. It feels like I’ve been kicked in the groin a few times. I have to stay completely flat for the next six hours. The biggest concern at the moment is making sure I’m not bleeding; the risk is high as I’m on blood thinners. My throat is sore and lungs feel congested. I cough a chunk of blood and become suddenly aware of the discomfort of the urinary catheter that I didn’t know I had. They assure me everything is OK. It’s very difficult to believe them given the circumstances. Six hours is a long time to lay flat and still when your body is wracked by all sorts of strange sensations and pains.
It’s a very long night. I’m exhausted but sleep won’t come. Closing my eyes only causes me to immediately focus on the sensations throughout my body. Instead of relief there seems to be more fear and anxiety on this end of the surgery than when I went in. All of this is apparently based on faith. On letting go. On complete trust that when they tell you things are fine that they are, despite what you may be feeling or fearing. Minutes tick by on the clock. 1AM. 2AM. Lusi stays the night with me. She’s been so good to me throughout all of this, dealing with all my irrationality and fear and anxiety, the sleepless nights, constantly giving. I’d have certainly gone mad without her there, her presence and distraction being entirely necessary to keep from entering a panic. The night is a haze of waiting, nurses taking vitals, and laying there in discomfort until I’m eventually released to go with instructions and a new bag of medications the next day. It is a huge relief to be set free, to be outside and on my way home. It is also a time of great stress as I’m now on my own, left to deal with all the strange feelings and pains without the security of doctors and nurses nearby. It is a little hard to believe that I’m ready to go home given what has just been done to me. Fighting back this fear and anxiety seem to be the the first hurdles of recovery. I’m new to this.
I come home to hand drawn “Welcome Back” signs from my children, who also saw it fit to hide and try to jump out and surprise me, no doubt the doctor recommended way of welcoming home someone who has just had heart surgery.
I lose it, they lose it, and we’re a mass hugs and tears.
And now it’s healing time. Sleeping time. Time to try and overcome anxiety and fatigue and chest pains and simply rest.
A Will Oldham song and video that somehow make too much sense to me right now: