Not everyone functioning in a specific career field has the same skill level. Some football players are better than others. Some plumbers are better than others. And some cardiologists are better than others. The cardiologist I was referred to spent eleven minutes and thirty seven seconds with me. He made semi-appropriate listening gestures while I explained the problem, and then did a hand-wavy thing while saying that, "...98% of these things are age related." He prescribed a diuretic and referred me to a sleep center to check for sleep apnea. To me this experience was total mierda de toro. I didn't fill the prescription, never went to the sleep center, and told my primary care doctor to give me another referral, which he did without question.
Before going on I want to comment a bit about my very brief experience with the sleep center the cardiologist had referred me to. Someone at that center contacted me by phone the following week. She said I needed to schedule three separate visits; one to pick up a device for me to use overnight at home, a second visit to do an overnight examination at the clinic, and a third to fit me for a CPAP machine. My question to her was, "Without knowing the results of the first or even the second test, how do you know I will need a CPAP machine?" Her response was that maybe we should schedule the first two visits and see what happens from there, and if a CPAP was required I shouldn't worry about it because my insurance would pay for it.
The difference between the first and second cardiologist was like night and day. This man asked in depth questions, listened, actually took notes, and then concluded the interview by saying that he needed time to review and digest my situation, and that his nurse would be in contact with me soon to suggest an action plan. I was more than satisfied with his approach. Maribel and I walked out feeling that something good was going to come out of this.
Three days later the cardiologist's nurse called me to say that I had been scheduled for two out-patient exams at a Chattanooga hospital. First was an ultrasound. The second was a nuclear stress test. Without getting into detail, this is a test designed to determine the level of blood flow to the heart. I didn't know it at the time but this is the test that ultimately determined the course of my life up to the present. Four days later the nurse called and said the stress test showed some areas of possible concern; that I needed another exam and that she would call me with the what, when and where.
The what turned out to be an angioplasty at that same Chattanooga hospital on Friday, February 28, 2020 at 3:00 PM. Reading up on the angioplasty procedure made me a little nervous. I knew that the cardiologist would be looking for blockages, and possibly opening them with a balloon or stent placement if found. I have never had any of the usual symptoms of blockage so couldn't imagine what would be the outcome of this procedure. But at least it was out patient and I would be going home to meet later that evening with our friends at a favorite fish fry restaurant and chug a few beers. Things don't always go according to plan.
I was semi-awake during the procedure but not aware of what was happening. I knew there were a lot of people in the operating room and could see a screen that apparently showed my heart and veins but wasn't coherent enough to ask questions or comment. After what seemed like a brief time I came out of the fog in a recovery room, with my cardiologist standing over me. When the cardiologist decided that I was alert enough to understand he drew a diagram on a white board showing the major veins to my heart and indicating that he had found blockages of 90%, 80%, and 75% in three of them. He also had photos and showed them to us. His words to me and Maribel who had joined me were, "....your condition is very serious and if you leave this hospital without cardiac surgery you will probably not have the opportunity to return." All of my protests; that I did not have one single symptom indicating blockage, no chest pain, no shortness of breath, no tingling, no dizziness, no nothing were useless. The evidence was there and undeniable.
It took only moments for Maribel and I to agree that we had no option. The cardiologist left the room and shortly after a nurse practitioner associated with a cardiac surgeon entered and told us he had scheduled me for a triple-bypass on Monday. Sort of in desperation I asked him if he had seen the angioplasty images and if he concurred with the cardiologist's opinion. He said he had seen the images and in his opinion, " ...you could die in your sleep tonight or on the street tomorrow. You are a walking dead man." I didn't expect an answer that blunt but appreciated it. It confirmed the decision to go ahead, which meant I had the whole weekend in a hospital to think about it.
A hospital room is not a good place to rest, relax or sleep. There is a constant parade of staff at all hours coming and going to take blood, measure vitals, dispense medications, clean the room, deliver and retrieve meal trays, and to wheel you down a refrigerated corridor into a refrigerated elevator and then into a refrigerated room for x-rays or any of several other exams that you weren't told about beforehand. I actually enjoy an ultrasound exam, because it's painless, non-invasive and is done with what I call the death machine. A technician lays you back on a cart, and rubs a small instrument over your belly or chest depending on what they're looking for, while looking at a screen. Periodically the machine will emit a loud noise that to me sounds exactly like a Darth Vader computer voice repeating three times...die!....die!....die!
A piece of hospital equipment that I absolutely detest is what I call The Beast, also known as an IV pole.
Hanging on the top of the pole is a bag of whatever liquid is being pumped into you. For me it was a blood thinner. A tube extends from the bag to some sort of calibration machine. Another tube exits the calibration machine and leads to the IV in your arm. For your entire hospital stay you are tethered to The Beast 24/7. You need to pee? Get out of bed, unplug the machine from the wall outlet, wheel it into the restroom with you, do your thing and then reverse the process, all without knocking it over or banging into something else, or getting the tube tangled with something and pulling the IV from your arm. In the wee small hours of the morning, after the technician has drawn your blood at 2:00 AM but before someone comes to take your vitals at 6:00 AM there is a brief opportunity to sleep, but The Beast knows this, and will choose this time to start beeping. What this supposedly means is that the IV bag needs to be replaced, but in actuality there is still liquid in the bag and anyone of the staff who happens to hear the beeping will see that, and simply push a button on the calibration machine to stop the beeping and tell it there is still liquid in the bag.
But to do that someone has to respond, which was not the case for me. See, the nurse's station doesn't know that your Beast is beeping. You have to push the call button to tell someone. The speaker on my call button didn't work. So the sequence was that the Beast beeps, I push the button, a voice asks "Can I help you? I respond that my IV is beeping. There is a pause and then again...Can I help you? I again reply that my IV is beeping. There is a click and no one comes. So I lay there listening to the beep until a staff member arrives for some other purpose. This happened many times during the next two days. On on occasion I got angry. It was about 3:00 AM and I had been listening to the beep for about thirty minutes when I got up, unplugged the Beast and wheeled it down the corridor to the nurses station. I told the staff sitting there that, "If you won't come to me I'll come to you." When they asked why I didn't use the call button, I could not make them understand that the call button didn't work.
The next morning when my cardiologist stopped in to see me I lost my cool. I told him that the customer focus in this place is terrible: that I have a faulty call button and no one seems to care. He responded that, "You're talking to the man who can fix this", and walked out. For the rest of the day there was a parade of hospital representatives in my room, apologizing and assuring me that better attention would be paid. One was a nurse supervisor who conducted an experiment with my call button and saw for herself that it didn't work. To her credit, she looked at me apologetically and said that even if the staff member responsible for responding to the patient call could not hear me, they still should have come into the room. She said she would put in a work order to have the call button replaced. Again to her credit, a maintenance man appeared an hour later and replaced the faulty call button.
In hind sight I had over reacted, and was especially rude to the nurse on duty the night I rolled The Beast out to the nurse's station. The next day I apologized to the doctor and all of the staff members including the nurse I had verbally abused. I'm getting ahead of my self now, but on the day I checked out that nurse came to my room and said, "I want to apologize to you for that earlier incident. It was my fault because I didn't come into your room." That was classy.
Anyway, Saturday and Sunday went by quickly. Maribel was there, and visitors included Jim and Marge, Dave and Vicky, my neighbor Ted and several others. Pete and Kim were on a cruise ship but I know they where with me in spirit. There were phone calls from out of state friends and family, and emails from friends and family in Peru. Maribel was feeling unsettled and not looking forward to staying in our house alone. Jim and Marge took her in for the next three days, and I will always be grateful to them for that.
Monday was pretty much of a blur for me. I remember a nurse shaving me, and being given pre-op medications. A crew wheeled me down to a pre-op room at about 1:00 PM. Most of them were middle aged guys, and somehow we got to talking about old days, and listening to Joe Louis fights on the radio. It didn't occur to me until later that these guys weren't old enough to be listening to Joe Louis fights. At one point I said I had better shut my mouth and let them get on with their work but someone protested that they were enjoying the conversation. A few minutes later an anesthesiologist told me that he was going to introduce some of his "home-made juice" into my IV. The last thing I remember was me saying that the old radio was probably made by GE or Philco.
In the distance I heard a male voice saying it was time to wake up. I assumed he was speaking to me so I responded, "Why are you waking me up? I have an operation scheduled." The voice said "You're done." I responded, "I can't be done..I'm being prepped for surgery." The voice said, "You're in recovery...it's over." Talk about complete disorientation. It seemed to me that my comment about a Philco radio was less than a minute ago. It was actually six hours.
Maribel and Marge had been sitting in the family waiting room the whole time, and were relieved when the surgeon told them that everything was fine, and commented that when he opened up my chest he was surprised at the condition of my heart. He said my heart is that of a forty-nine year old rather than seventy-nine. He told Maribel that she could see me but cautioned her that it was late, I was sedated, had "miles of tubes in me" and probably would not know she was there. She and Marge opted to go to dinner and then to Marge's house to pack it in for the night. I have no memories of that evening; how or when I was taken to my room or anything else. Nor do I remember anything from the following morning.
In the afternoon Maribel was there. There were a zillion tubes attached to me in every possible location, and next to me was a heart-shaped red pillow that the nurse who had given it to me called 'brave heart.' She instructed me to hold it very tightly to my chest and place my chin in it when the pain came. When I moved, my chest and the leg where the by-pass veins had been taken from were sore but so far I had no real pain. I wasn't able to eat mostly because the food tasted terrible and I had no appetite, but did drink some juice. Shortly after the juice I started burping, and now I knew what the pillow was for. With each burp it felt like every single Marvel Comics superhero and villain were simultaneously firing all their weapons at my chest. Maribel hurriedly left the room to look for a nurse, but a nurse standing outside heard my groans and told Maribel that what was happening was normal. For that day and the next every burp, sneeze or cough produced level eight pain. The surgery took place on Monday, and by Wednesday evening the pain had subsided enough to allow me to get out of bed and move about the room. On Thursday there was no pain at all, and I was able to take long walks in the hospital corridors, though still attached to The Beast. Thursday morning I was telling anyone who would listen that I was ready to go home but the answer was always the same, "Not until you've had a bowel movement." I tried...believe me I tried. I don't know how many times I disconnected The Beast from the wall and dragged it into the restroom but no luck. Thursday afternoon the doctor ordered two medications that were supposed to induce a bm quickly. Nada. Friday morning a nurse inserted a suppository, and guaranteed results within the hour. She was right.
It was at 3:00 PM on Saturday, March 7, 2020 that a nurse wheeled me to the front entrance where Maribel was waiting with the car. My only thought upon leaving that hospital and getting into the car was...it's over.
Upon arriving home I sat on the couch for awhile, and then with Maribel's help took my first complete shower in a week. The shower was more difficult than I expected, as was changing into fresh clothing. It was difficult to breathe; more so than it had been at the hospital the last two days. I assumed it was because of all the movement I was doing. Saturday evening was spent sleeping on the couch.
When I awoke Sunday morning I knew something was wrong. My breathing was shallow and rapid, and my blood pressure was 84/54. I called my insurance company's nurse hotline, explained my situation and was told to hang up and dial 911. Maribel drove me to a nearby emergency room where I was examined and told that the best course of action was for me to transfer back in an ambulance to the hospital I had left yesterday, as this hospital was not equipped to treat my condition. That was the last thing I wanted to do, but given my condition it made sense, so two hours later I was back in the hospital I had left yesterday, just three doors down from my previous room.
For the next two days my breathing problem continued, and a battery of tests did not find the cause. Two specialists examined my lungs and found no lesions, or water in them. They concluded that my lungs were 100% and not part of the problem. Another ultrasound was done, with no problem found. My cardiologist told me to prepare for an angioplasty that afternoon. As with the first one, I was awake but this time more alert and was following what was happening and being said. I knew that some blockage had been found and that a stent was being inserted. Immediately upon completion of the procedure I could feel that my breathing had improved. I asked one of the attendants how that could happen so quickly, and he responded, "Welcome to the world of normal breathing!" I joked that I wanted to get back to my room so that I could test drive my new body. I deliberately took deep gasps of air through my nose and savored each one.
On Thursday, March 12, 2020 I was again being wheeled to the main entrance where Maribel was again waiting with the car. That was one month ago as of the day of this writing. Since then I have mowed our lawn twice; washed our car, taken walks of 1.5 miles without stopping, and have cut up and burned fallen tree limbs in our yard. I haven't resumed weight lifting yet but when my body tells me its ready I will. It's been one hell of a ride but there has been some upsides. My blood pressure is lower than it's ever been, and no more spikes. All of the doctors who examined me said that my major organs are in great shape, that I am overall in good condition and that there is no reason why I can't live another twenty years. I'm shooting for twenty one. Then I could write a 100 year birthday post.
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